Sacred Heart Hospital Employees Credit Union

Loan Application Form

Please type information, print & forward to the Credit Union

Check type of credit applying for:
Individual-Unmarried (complete top half form only) Joint-with Spouse (complete top & bottom of form)
Individual-Married (complete top & bottom of form) Joint-with non-spouse applicant *
Check type of Loan: Installment Line of Credit
Loan amount: No. Payments:
Purpose:
Wisconsin Residents Complete:
Check Applicant Type: Married Unmarried Legally Separated
Check Co-applicant Type Married Unmarried Legally Separated
1st Name: Middle Name: Last Name:
Address : How long?  
City:    State: Zip:
Phone:   Social Security #: Birthday:
Employer: Position: How long?
Job Address: Job Phone  
Gross Mo. Inc. Other Inc.** Other Inc Source
Housing Payment: Mortgage Bal. Market Value:
Mortgage holder/Landlord:

** 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 loan.

Other Debts: (loans, credit cards, med bills etc.)
Creditor Balance due Month Payment

End of top half of form 

If complete Please print & forward to the Credit Union

Bottom Half (for Individual-Married; or Joint Applications)

Check applicable: Spouse Co-applicant
Name of Spouse or Co-applicant 
Phone Social Security # Birthday
Employer Position How Long
Job Address Job Phone  
Gross Mo Inc Other Inc. Source Oth Inc
Other Debts: (loans, credit cards, med. bills etc.)
Creditor Balance Due Month Payment

Please print & forward to the Credit Union

You agree that everything stated in this application is correct to the best of your knowledge.  The Credit Union is authorized to investigate your creditworthiness, employment history, and to obtain a credit report to answer questions about their credit experience with you.  You understand that any false or misleading statement in your application may cause any loan or extension of credit to be in default.  You authorize us to accept your facsimile signature on this application and agree that your facsimile signature will have the same legal force and effect as your original signature.  You assume any risk that may be associated with permitting us to accept your facsimile signature.

Notice to Wisconsin Residents  No provision of a marital property agreement, a unilateral statement under Wis. Stat. Sec 766.59 or a court decree under Wis. Stat. Sec 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.

If I/we am/are married, applying for individual credit, and living in a community property state, I/we certify that the credit being applied for, if granted, will be incurred in the interest of the marriage or family.  If this statement applies, we are required by Wisconsin law to notify your spouse by mail if your loan is granted.  By pressing the “Submit Application” button, you agree to the above statement.  You understand that we may require additional information to finalize our credit decision and your signature on additional documents prior to disbursing any credit proceeds.