Welcome to Thameville Community Credit Union

Fill out the information below to apply for a loan with the credit union. Please complete information for both Applicant and Spouse, if applicable. * Required Field

APPLICANT PERSONAL INFORMATION:
First Name	* Last Name *
Date of Birth (mm/dd/yy)
Street Address
Address (cont.)
City
Province	Postal Code
Email Address	*
How long?	Years
Work Phone	Home Phone *
Marital Status	*
No. of Dependents
Legal Judgments?	Yes No

SPOUSE PERSONAL INFORMATION:
First Name	Last Name
Date of Birth (mm/dd/yy)
Street Address
Address (cont.)
City
Province	Postal Code
Email Address
How long?	Years
Work Phone	Home Phone
Marital Status
No. of Dependents
Legal Judgments?	Yes No

APPLICANT EMPLOYMENT INFORMATION:
Employer & Address
Position Held
Weekly Gross Income
How long?	Years Months

SPOUSE EMPLOYMENT INFORMATION:
Employer & Address
Position Held
Weekly Gross Income
How long?	Years Months

FINANCIAL INFORMATION:
Assets
Real Estate	Value $ Property Taxes $
Motor Vehicle 1	Make License Value $
Motor Vehicle 2	Make License Value $
RRSP's	Amount $ Held At
Other Assets (Please list)	Total Assets $
Liabilities
Mortgage Balance	$ Payment Amount $
Car Loan Balance	$ Payment Amount $
Credit Card Balances	Card 1 $ Card 2 $ Card 3 $
Other Liabilities (Please list)	Total Liabilities $
Additional Comments

I/We am/are not indebted to any other credit union, bank, loan agency, merchant (deferred payment), individual or other financial institution, as maker, co-maker, or guarantor except as stated above. The statements herein are made for obtaining the loan, and are true to the best of my knowledge and belief. A consumer report containing credit information is being or may be referred to in connection with the credit hereby applied for or any renewal or extension thereof. The undersigned consents to the obtaining of such personal or credit information as the credit union may require at any time in connection with the credit hereby applied for, or any renewal or extension thereof; and further consents to the disclosure of any information concerning the undersigned to any credit reporting agency, or any person with whom the undersigned has or proposes to have financial relations.