Cal Feminist FCU Short Form Loan Application 

Read Instructions first.  Questions?  info@feministcu.org or 619-298-SAVE (7283) 

We do not sell names/addresses or give phone #s to credit bureaus. 

  CFFCU use only above line  CU shr acct #________[ ]A   [ ]B   [ ]C     [ ]D   Date CU rec'd

Name____________________________________ CFFCU Savings Acc't #____________

Mailing Address_____________________________________________________

    City_____________________________ State_______ Zip Code_________________

Daytime                                  Evening                                   Pager or 

Phone #_______________Phone #_______________Cell #___________________ 

E-mail address_________________________________________________

LOAN TYPE (check one):    

[ ] Share-Secured Type II (someone has opened or will open a CFFCU savings account 

with $106 for every $100 I borrow) her or /his name_____________________________

[ ] Share-Secured Type I (I'll keep  in my CFFCU savings account $106 for every $100 I owe)

[ ] Credit Builder (funds I borrow will go into my  CFFCU savings and be “frozen”)

 

AMOUNT  I'll borrow:   $_______________  To pay for (what)? ___________________

Combine  this loan with existing loan [ ]a  [ ]b  [ ]c  [ ]d ? (check)  [ ]n.a.  [ ]no  [ ] yes   

REPAYMENT  preference (check one or both):  I want to pay off this loan:

    [ ] in (number of) _______ months.   [ ] at approximately $______________ per month.

DISTRIBUTION  of loan funds (check one):

       [ ] Put all $ in my CFFCU savings #__________

       [ ] Make check out to:  [ ] me    [ ] on my behalf  to:____________________________

       [ ] Make check out as above for $__________; put the rest in CFFCU savings #__________

PAYMENT  DATES:  Month 1st payment will be due:____________  Due date: [ ]5th     [ ] 20th 

        (First payment may be due no more than 45 days after loan is funded)

FUNDING Preference (check one): [ ] By  appointment: I'll contact you to learn when I can visit

your office.  [ ] By mail: send me a loan contract (check one) [ ]by post  [ ]attached to an e-

mail.  A Notary Public will watch me sign it; I'll mail it back; when you receive it, fund it. 

CREDIT INSURANCE OPTIONS (see Certificate of Insurance for details)

        Disability  (employed/self-employed at least 30 hours/week on date loan is funded; 

        expires at age 65 )  [ ] add premium to my loan balance         [ ] no thanks

Life  Insurance coverage expires at age 70  [ ] add  to my loan balance         [ ] no thanks

 

CREDIT HISTORY: 

1. Did you ever file for Ch. 7 or Ch. 13 bankruptcy?                                         [ ] yes     [ ] no

2. Have all bankruptcies been discharged?                                        [ ]n.a.      [ ] yes     [ ] no

3. Did you ever cause a loss to CFFCU that hasn't been  fully  repaid?          [ ] yes     [ ] no

4. Did you ever cause  another credit union  a loss?  [ ]yes   [ ]no.  If yes, has the loss been

    100% repaid?  [ ]yes      [ ]no

 I certify under penalty of perjury that the info on this app. is true, correct, and complete. If I do 

not  return loan documents you prepare for me in time to have my loan funded w/in 30 days of

approval, deduct from my shares your fee  to compensate for your time.

 

 SIGN     X _______________________________________________  Date__________

 

Cal Feminist members*:  please print out this form, complete it, and either Fax it to:  619-298-1412  or 

    Mail it to: Cal Feminist FCU ~ PO Box 16587  ~ San Diego CA 92176.  

    * If you're not yet a member, mail or bring it in with your new account forms and check(s)

========Cal Feminist use only below this double line=============================

$____________ am't approved by: [ ]Loan Officer or [ ] Credit Committee on (date)_________

Approval Signature(s): (one if Loan Officer, two if Credit Committee)

    ___________________________    ________________________