ONLINE BANKING

Loan Application

Application for Personal Credit

AMOUNT

PURPOSE

IF YOU ARE PURCHASING A PROPERTY

Purchase Price

Down Payment

Closing Date

Down Payment Source

Personal Information

Last Name First Name
Address City
Province Postal Code
Telephone
How long at
present address
If less than 3 years,
previous address
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 Information

Last Name First Name
Birth Date (dd/mm/yy)
Employer's Address Employer's Telephone
Occupation (Job Title) Gross Income
Other Income How long at
present employer
If less than 3 years,
previous employer

Residence Information

Residence If Rent, monthly rent

IF YOU OWN

How is home registered Purchase Price
Estimated Resale Value Mortgage Payment/Month
Annual Property Taxes Condo Fees/Month

Assets

VALUE

Residence
Other Real Estate
Cash (institution name)
Auto (make, model, yr.)
RRSP's
Stocks/Bonds
Other Assets

Liabilities

WHERE

BALANCE

MONTHLY PAYMENT

Mortgage
Personal Loans
Credit Cards
Lines of Credit
Leases
Alimony/Support

IN THE EVENT OF QUESTIONS, PLEASE CONTACT

AT

In submitting this on-line application to TALKA LITHUANIAN 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 maid 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.

BY PRESSING SUBMIT YOU AGREE TO THE ABOVE TERMS AND CONDITIONS.

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