How To Apply:

- Please complete all pages of this form

-Incomplete / incorrect information may delay processing

-Proof of income will be required before loan can be finalized

Individual Credit: You must complete an application about yourself. Your Spouse must also submit an application if:
1. you live in or the property pledged as collateral is located in a community property state (AK,AZ, CA, ID, LA, NM, NV, TX, WA, WI),
2. Your spouse will use the account
3. You are relying on your spouse's income as a basis for your repayment.

Joint Credit: Each Applicant must individually complete the application.

Please fill out information below to indicate the type of credit for which you are applying.

Check if coverage is desired. The Credit Union will disclose the cost of this coluntary insurance to you. A separate insurance election which discloses the terms and conditions must be signed for the coverage to become effective.

Notice: Alimony, Child Support, or Separate maintenance income need not be revealed if you do not choose to have it considered.

Please enter the name and contact information of the nearest relative not living with you.

I promise that:

· I am the person named in this application.

· Everything I have stated in this application is correct to the best of my knowledge.

· The above information is a complete listing of what I owe.

· If there are any important changes I will notify the credit union in writing immediately.

I authorize Jamestown Area Community Federal Credit Union to obtain credit reports in connection with this application for credit and for any update, renewal, or extension of the credit received.

I understand that

· The Credit Union will rely on the information in this application and my credit report to make its decision.

· If I request, the Credit Union will tell me the name and address of any credit bureau from which it received a credit report on me.

· It is a federal crime to willfully and deliberately provide incomplete or incorrect information on loan applications made to federal credit unions or state chartered credit unions insured by NCUA.

Thank you for applying for credit with Jamestown Area Community FCU.  You will be contacted regarding your application on the next business day.