DPS Federal Credit Union - Christmas Loans

Amount Requested

Purpose/Collateral

Christmas Loan/Personal

Repayment

Payroll DeductionCashMilitary AllotmentAutomatic Payment

Are you interested in having your loan protected?

YesNo

First Name

Last Name

SSN

Driver's License #

Age of Dependents

Birth Date

Home Phone

Mobile Phone

Business Phone/Ext.

Present Address

Address

City

State

ZIP Code

Do you rent or own this residence?

OwnRent

Length at Residence

Previous Address

Address

City

State

ZIP Code

Did you rent or own this residence?

OwnRent

Length at Residence

Employment/Income

Employer

Address

City

State

ZIP Code

Title

Start Date

Hours at Work

Supervisor's Name

If Self Employed, Type of Business

Employment Income

Other Income

Military: Is duty station transfer expected during next year?

YesNo

Previous Employer

Address

City

State

ZIP Code

Starting Date

Ending Date

Reference

Name

Address

City

State

ZIP Code

Relationship

Home Phone

Other Information

Are you a U.S. Citizen or permanent resident alien?

Yes
No

Do you currently have any outstanding judgments or have you ever filed for bankruptcy, had a debt adjustment plan confirmed under chapter 13, had property foreclosed upon or repossessed in the last 7 years, or been a party in a lawsuit?

Yes
No

Is your income likely to decline in the next two years?

Yes
No

Signature

You promise that everything you have stated in this application is correct to the best of your knowledge. If there are any important changes you will notify us in writing immediately. You authorize the Credit Union to obtain credit reports in connection with this application for credit and for any update, increase, renewal, extension or collection of the credit received. You understand that the Credit Union will rely on the information in this application and your credit report to make its decision. If you request, the Credit Union will tell you the name and address of any credit bureau from which it received a credit report on you. It is a crime to willfully and deliberately provide incomplete or incorrect information in this application.

Christmas Loans

Applicant Information

Present Address

Previous Address

Employment/Income

Reference

Other Information

Signature

ATM Zone