BUCKEYE STATE CREDIT UNION
LOAN APPLICATION
BUCKEYE STATE CREDIT UNION, INC.
Your location:
Akron
Alliance
Ashtabula
Canton
Painesville
Note:
Shaker Heights / Dublin area members please select the Akron location
PERSONAL INFORMATION
Name
Home Phone
Social Security
Birth Date
Home Address
City
State
Zip Code
Since
Email Address
EMPLOYER INFORMATION
Employer
Phone
Job Description
Hire Date
Employer Address
City
State
Zip Code
Previous Employer
No. Years/Months
Termination Date
INCOME INFORMATION
Income: Please Attach Verification of Income.
Alimony, child support, or separate maintenance income need not be revealed if you do not wish to have it considered as a basis for repaying this obligation.
Year
Reg. Income *
Overtime
Other Income
Other Description
Year
Reg. Income *
Overtime
Other Income
Other Description
* Please Note As To Whether Income is Per Hour, Week, Month, or Year.
Will any income listed be reduced before loan is paid off? No
Yes
If yes, explain
Nearest Relative Not Living with You
Relationship
Phone
Address
City
State
Zip Code
If you are applying for this loan with a co-applicant/spouse, you must also fill in all the information in the gray background sections below. Otherwise, skip the gray background sections and continue.
CO-APPLICANT/SPOUSE PERSONAL INFORMATION
Co-Applicant/Spouse
Home Phone
Social Security
Birth Date
Home Address
City
State
Zip Code
Since
CO-APPLICANT/SPOUSE EMPLOYER INFORMATION
Co-Applicant/Spouse Employer
Phone
Job Description
Hire Date
Employer Address
City
State
Zip Code
CO-APPLICANT/SPOUSE INCOME INFORMATION
Co-Applicant/Spouse Income: Please Attach Verification of Income.
Alimony, child support, or separate maintenance income need not be revealed if you do not wish to have it considered as a basis for repaying this obligation.
Year
Reg. Income *
Overtime
Other Income
Other Description
Year
Reg. Income *
Overtime
Other Income
Other Description
* Please Note As To Whether Income is Per Hour, Week, Month, or Year.
Will any income listed be reduced before loan is paid off? No
Yes
If yes, explain
Loan Purpose
Amount Requested
Payment
Collateral/Security Offered
Months #PAY:
Months FREQ:
The above information is true to the best of my knowledge. I hereby authorize the Buckeye State Credit Union or its designee to obtain any information relevant to my application for a loan. Also, I authorize BSCU to obtain a report of my credit history and signature prior to disbursement of loan.
Member: I hereby attest that the above statement is true.
I Agree
Application Date
NOTICE TO ALL OHIO RESIDENTS:
"The Ohio laws against discrimination require that all creditors make credit equally available to all credit worthy customers, and that credit reporting agencies maintain separate credit histories on each individual upon request. The Ohio Civil Rights Commission administers compliance with this law."
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