NOTICE TO OHIO RESIDENTS: The Ohio laws against discrimination require all
creditors make credit equally available to all credit worthy customers, and that credit
reporting agencies maintain separate credit histories on each individual upon request. The
Ohio Civil Rights Commission administers compliance with this law.
WISCONSIN RESIDENTS ONLY: (1) No provision of any marital property agreement, unilateral statement under Section 766.59, or court decree under Section 766.70 will adversely affect the rights of the Credit Union unless the Credit Union is furnished a copy of the agreement, statement or decree, or has actual knowledge of its terms, before the credit is granted or the account is opened. (2) Please sign if you are not applying for this account or loan with your spouse. The credit being applied for, If granted, will be incurred in the interest of the marriage or family of the undersigned.
IN SUBMITTING THIS FORM: You promise that everything you have stated in this request is
correct to the best of your knowledge. If there are any important changes, you will notify
us in writing immediately. You also agree to notify us of any change in your name, address
or employment within a reasonable time thereafter. You authorize the credit union to
obtain credit reports in connection with this request. If you request, the credit union
will tell you the name and address of any credit bureau from which it received a credit
report on you. You understand that it is a federal crime to willfully and deliberately
provide incomplete or incorrect information on requests made to Federal Credit Unions or
State Chartered Credit Unions insured by the NCUA. You understand that the credit union
will rely on the information in the request and your credit report to make its decision.
By submitting this loan request, you agree that the information is correct to the best
of your knowledge. You also agree to notify us of any changes to your name, address or
By submitting this loan application you authorize the credit union to obtain credit reports in connection with