You Must be a Member of GEFCU to Request Funds.
Please print this form and complete and sign at bottom.
You may fax it to 512-836-3732 or mail to GEFCU P.O. Box 81535, Austin, TX 78708-1535.
REQUEST FOR FUNDS
I request an advance of $_____________________________Purpose of request_____________________________ _______________________________________________________________________________________________
I offer the following security for this advance:
q Shares Acct.No.______________________      
q Vehicle 1 Year ______________ Make __________________ Model __________________ ID#_____________
q Vehicle 2 Year ______________ Make __________________ Model __________________ ID#_____________
q Other (Describe) ______________________      
THIS APPLICATION IS FOR
q An Individual Account Name of Co-Applicant
q An Account with my Spouse _____________________________________________
q An Account with someone other than my Spouse (Co-Applicant) Is this your first loan with GEFCU?
NOTICE: Married Applicants may Apply for an Individual Account _____________________________________________
GENERAL INFORMATION
Applicant's Name Credit Union Account No.
Street Address City,State,Zip How Long?
Previous Address if less than 2 years City,State,Zip How Long?
Home Phone No. Office Phone No. Social Security No.
Date of Birth Dependents Excluding Self
No. Ages
DL# State Issued
EMPLOYMENT
Present Employer Date Employed Applicant's Salary
q Semi- Monthly q Monthly q Annual
q Bi-Weekly q Weekly  
Gross $

Net $
Address (Street,City,State,Zip)
Job Title Previous Employer Address
REFERENCES
Nearest Relative Not Living With You Phone No.
Relative's Address (Street, City, State, Zip)
ASSETS AND INCOME
Auto if clear of financing Year Make Model State Titled In 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.
Savings at other
qCredit Union qS&L qBank
Name, City & State Source of other Income Monthly $
Savings at other
qCredit Union qS&L qBank
Name, City & State Source of other Income Monthly $
Savings at other
qCredit Union qS&L qBank
Name, City & State Source of other Income Monthly $
SPOUSE/CO-APPLICANT
Complete this section if: (1) this is to be joint account with your spouse, (2) your spouse/co-applicant will use this account, (3) you live in a community property state (Arizona, California, Idaho, Louisiana, Nevada, New Mexico, Texas, Washington, or Puerto Rico), or (4) you are relying o your spouse's/co-applicant's income in applying for this account. This section must also e completed about your co-applicant if this is for a joint account with someone other than your spouse
Spouse/Co-applicant's Name
 
Social Security No. Credit Union Acct. No.
Address (Street, City, State, Zip)
 
Date of Birth Office Phone
Present Employer How Long
Applicant's Salary
q Semi- Monthly q Monthly q Annual
q Bi-Weekly q Weekly  
Gross $
 
Net $
Address (Street, City, State, Zip)
 
Job Title Date Employed
LIABILITIES AND LOANS
Creditor/Credit Cards Loan Date Org. Debt Present
Balance
Monthly
Payment
Past Due
Yes/No
1st Mortgage on Home/ Landlord
qLeasing qBuying qRenting
         
2nd Mortgage on Home          
Loan or Contract on Car          
2nd Car          
Credit Union Loans          
Child Support          
Child Care          
Credit Cards/ Charge Accounts
(Please List Separately)
         
           
           
           
           
           
           
Totals          
Are there any other persons obligated on any of the above loans? q No qYes

Which ones and who?________________________________________________________________________________________________

Are you a co-maker, co-signer or guarantor on any loan? q No qYes

For whom? _______________________________________________________ To whom?________________________________________

Have you been the subject of an order for relief under The Federal Bankruptcy Code or adjudicated a bankrupt under the Bankruptcy Act in the last 10 years? q No qYes

Everything that I have stated in this application is correct to the best of my knowledge. GEFCU is authorized to check your credit, employment history, obtain a credit report and to answer questions about your credit experience with them. You understand that it may be a federal crime punishable by fine or imprisonment, or both, knowingly to make any false statements concerning any of the above facts as applicable under the provisions of the U.S. Criminal Code. Additional information may be required.

Signature of Member ______________________________________________________ Date______________________________________ Co-applicant ______________________________________________________ Date______________________________________

Credit Committee / Loan Officer Action
For Credit Union Use Only
 
Loan Officer:
  q I approve the loan as submitted.              
  q Loan referred to C.C. Reason ____________________________________________

LO Signature ___________________________________________________________ Date _______________________________________

Credit Committee: Date _____________________      
q We approve the loan as submitted.              
q We reject the loan as submitted.  
  Debt Ratio B _____ % Co-Applicant Debt Ratio B _____ %            
  Debt Ratio A _____ % Co-Applicant Debt Ratio A _____ %            
  Credit Report _____ Date Credit Report Co-Applicant _____ Date            
  Auto Loan Dealer Work Sheet _____ Purchased from Individual _____            
Specific reason(s) for rejection
Outside information considered q No qYes (describe) ___________________________________________________________________
Conditions, if any: ________________________________________________              
Signed ________________________________________________ Date_____________________________________            
                 

Equal Housing Lender