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University of Wisconsin Oshkosh

Staff and Board Member Area

 

 
Instructions: Please fill out the application below and click on the submit button.
Loan Information
 
Member number:
 
Amount Requested:
 e.g 99999.99
 
Purpose of Loan:
Preferred Method of Payment Installment Line Of Credit
Installment Line Of Credit
 
Number of Payments:
Applicant's Contact Information
 
Applicant Name (Last, First, Middle):
 
Marital Status (Single, Married or Divorced):
 
Permanent Street Address:
 
City:
 
State:
 
Zip:
 
Home Phone:
 e.g (999) 999-9999
 
How long have you lived at this at this address?
e-mail:
Other Information
 
Gross Monthly Pay:
e.g: 99999.99
 
Social Security Number:
e.g 999-99-9999
 
Other Income:
e.g: 99999.99
 
Source:
Household Information
 
Mortgage Holder or Landlord:
 
Mortgage Holder or Landlord's Address:
 
Landlord's Phone:
e.g (999) 999-9999
 
Mortgage or Rent Payment:
e.g: 99999.99
 
Original Amount:
e.g: 99999.99
 
Balance Due:
e.g: 99999.99
 
Market Value:
e.g: 99999.99
Employment Information
 
Employer:
 
Position:
 
How Long?
 
Business Address:
 
Business Phone:
e.g (999) 999-9999
 
Business City/State/Zip:
Co-Applicant-Contact Information
 
Co-Applicant Name (Last, First, Middle):
 
Marital Status (Single, Married or Divorced):
 
Permanent Street Address:
 
City/State/Zip Code:
 
Home Phone:
 e.g (999) 999-9999
 
How long have you lived at this at this address?
Other Information
 
Gross Monthly Pay:
e.g: 99999.99
 
Social Security Number:
 
Other Income:
e.g: 99999.99
 
Source:
Household Information
 
Mortgage Holder or Landlord:
 
Mortgage Holder or Landlord's Address:
 
Landlord's Phone:
 e.g (999) 999-9999
 
Mortgage or Rent Payment:
e.g: 99999.99
 
Original Amount:
e.g: 99999.99
 
Balance Due:
 e.g: 99999.99
 
Market Value:
 e.g: 99999.99
Employment Information
 
Employer:
 
Position:
 
How Long?
 
Business Address:
 
Business Phone:
e.g (999) 999-9999
 
Business City/ State/ Zip:
   
   
PLEASE PRINT THE NEXT PAGE THAT APPEARS FOR YOUR RECORDS

NOTE: 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.

NOTICE TO MARRIED APPLICANT: No provision of a marital property agreement, a unilateral statement under Wisconsin Statutes Section 766.59 or a court decree under Wisconsin Statutes Section 766.70 adversely affects the interests of the credit union unless prior to the time the credit is extended, the credit union is furnished with a copy of the agreement, statement, or decree, or has actual knowledge of the adverse provision when the obligation to the credit union is incurred.

This statement is submitted to obtain credit and does not constitute a contract for the extension of credit. I (We) certify that all information herein is true and complete. I (We) also authorize the credit union to verify or obtain any additional information the credit union may deem necessary concerning my (our) credit standing from credit bureaus, collection agencies, and any other source. The credit union may release information about its credit experience with me (us). I (We) understand that it may be a Federal crime punishable by fine or imprisonment, or both, to knowingly make any false statements concerning any of the above facts, as applicable under the provisions of Title 18, United States Code, Section 1014.

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E-mail us at uwoshcu@uwosh.edu.  We will get back to you within one business day.
Copyright © 2006 UW Oshkosh Credit Union
Last modified: 4/29/08