LoanApplication

Varian Credit Union

Please fill out the form in it's entirety.

Online Loan Application

Married applicants may apply for a separate account. If you are applying for Individual Credit you must complete the Applicant section about yourself and the Co-Applicant section about your spouse if:

Your spouse will use the account, or

You are relying on your spouse's income as a basis for repayment.

If you are relying on income from alimony, child support or separate maintenance, complete the Co-Applicant section to the extent possible about the person on whose payments you are relying.
If you are applying for Joint Credit with another person, complete the Applicant and Co-Applicant sections.

Type and Amount Requested

First Loan from Us?	Yes No	Type of credit:	Individual Joint	Amount/Credit Limit Requested: $
Approximate time to repay: How Many? Period:				Loan Type:
Security Offered:

Payment Protection Coverage

Check if desired

Check coverage(s) desired. We will disclose the cost of this Payment Protection Insurance - Credit Disability and Credit Life - to you. A separate enrollment form which discloses the terms and conditions must be signed for coverage to become effective.

Do you want your loan protected for you and your family if you become disabled?

Do you want your loan protected for you and your family in the event of your death?

Applicants

Borrower

Full Name:
Account Number:	SSN:	Birthday:
Address	Own Rent	Years in home:
Drivers License:
Home Phone:	Work Phone:	Other Phone:

Co-Borrower

Full Name:
Account Number:	SSN:	Birthday:
Address	Own Rent	Years in home:
Drivers License:
Home Phone:	Work Phone:	Other Phone:

Income Information

Borrower

Amount: Income $	Per:	Gross:
Amount: Income $	Per:	Source:

Co-Borrower

Amount: Income $	Per:	Gross:
Amount: Income $	Per:	Source:

References

Borrower

Name and Address of Creditor Of Debts Payed Off	Telephone
Creditor Name and address	Telephone:
Name and Address of Nearest Relative	Telephone	Relationship
Name and Address Relative	Telephone:	Relationship:
Name and Address of a Personal Friend	Telephone
Friend Name and address	Telephone:

Borrower

Name and Address of Creditor Of Debts Payed Off	Telephone
Creditor Name and address	Telephone:
Name and Address of Nearest Relative	Telephone	Relationship
Name and Address Relative	Telephone:	Relationship:
Name and Address of a Personal Friend	Telephone
Friend Name and address	Telephone:

Debts

	Creditor Name and Address	Amounts	Past Due	Remove
Applicant Other Mortgage Rent	Creditor Name and address	Original $ Current $ Payment $
Applicant Other	Creditor Name and address	Original $ Current $ Payment $