Application for Personal Credit Loan InformationLoan Amount*Type of Loan*Select OnePersonal LoanLine of CreditMortgagePurpose of Loan*Purchase Price*Down Payment Amount*Closing Date* MM DD YYYY Down Payment Source*Personal InformationName* First Last Phone*Email*Address* Street Address City State / Province / Region ZIP / Postal Code How Long at Present Address?*If Less than three years,Birth Date (dd/mm/yy)*Marital Status*Number of Dependants*Employer's Name*Employer's Address*Occupation (Job Title)*Employer's Telephone*Gross Income*Other Income*How Long at Present Employer?*If less than 3 years, previous employer*Occupation (Job Title) with previous employer*Spouse's InformationName First Last Birthdate (dd/mm/yy)Employer's AddressEmployer's TelephoneOccupation (Job Title)Gross IncomeOther IncomeHow long at present employerIf less than 3 years, previous employerResidence InformationResidence*Select OneRentOwnWith ParentsOtherIf Rent, monthly rent*How is home registered*Purchase Price*Estimated Resale Value*Mortgage Payment/Month*Annual Property Taxes*Condo Fees/Month*AssetsResidence*Value*Other Real EstateValueCash (institution name)ValueAuto (make, model, yr.)ValueRRSP'sValueStocks/BondsValueOther AssetsValueLiabilitiesMortgageBalanceMonthly PaymentPersonal LoansBalanceMonthly PaymentCredit CardsBalanceMonthly PaymentLines of CreditBalanceMonthly PaymentLines of CreditBalanceMonthly PaymentLeasesBalanceMonthly PaymentAlimony/SupportContact InformationIn the event of questions, please contactWhere should we call you?HomeWorkTerms & ConditionsYou must accept our terms and conditions to submit a loan application*In submitting this on-line application to TALKA CREDIT UNION LIMITED, the applicants accept and consent to the following terms and conditions: If this loan is approved, I authorize the manager or his nominee to fill in the dates on the Promissory Note and Assignment of Wages. The undersigned is not indebted to any other credit union, bank, loan agency, store or individual merchant, either as maker or endorser, except as stated above. The statements herein are made for the purpose of obtaining the loan, and are true the best of my/our knowledge and belief. I AUTHORIZE THE CREDIT UNION TO OBTAIN SUCH FACTUAL AND INVESTIGATIVE INFORMATION REGARDING ME FROM OTHERS AS PERMITED BY LAW AND THE FURNISH OTHER CREDIT GRANTORS AND ANY CREDIT BUREAU, PARTICULARS OF THIS CREDIT APPLICATION. IN ADDITION, I HEREBY ACKNOWLEDGE NOTICE FROM THE CREDIT UNION THAT A CONSUMER REPORT CONTAINING CREDIT INFORMATION MAY OR WILL BE REFERRED TO IN CONNECTION WITH THIS APPLICATION FOR CREDIT OR ANY RENEWAL OR EXTENSION THEREOF. I agree to Talka Credit Union's terms and conditions.CAPTCHA This iframe contains the logic required to handle Ajax powered Gravity Forms.