Financial Details - The Co-op Credit Union



Loan Application

Personal Details

Surname (Mr/Mrs/Miss/Ms) …………………………..……………… Membership No ……..……..…

First Name ………………………………….……..….. Middle Name ……………..……………………

Home Address …………………………………………………………………….………………………

……………………………………………………………..…………. Post Code ………………………

Home Tel ……………………………………….. Work Tel ………………….…………………………

Mobile …………………………………………… Email ……..……………….………………………..

Date of Birth ………………………………. (applicants must be 18 yrs or over)

National Insurance Number __ __ __ __ __ __ __ __ __ No of dependants. …………………

Time at current address ………….……… Owner ( Tenant ( With Parents ( Lodger (

(if less than 3 years, please provide details of your previous address below)

………………………………………………………………………………………………..………………

If owned, approx value £ ……….…………… If mortgaged, approx mortgage £ …....……………

Mortgage provider ……………………………………………………. Term remaining ………………

Employment Details

Employee/Payroll No …………………..……………… Pension No ………………………………….

Employer ………………………………….……… Dept ……….. ………………………………………

Address: …………………..………………………..…………………………………………………....

….…………………..…………………….…………………………………….Post Code ……………..

(Manchester Sites: Floor ………… Building …………………………………………………………)

Date employment commenced ……………………..………….. Full time/part time …….………….

Loan Details

Loan amount requested £ …………….……… over ….…………… months/4wkly pay periods.

Please indicate type of loan: Standard ( Starter (

Purpose of loan ………………………………………………… Estimated total cost £…………….

I wish to continue to save £……………… per month/4 weeks

You must continue to save a minimum of £10 per month/4 weeks in you main share account whilst repaying your loan. The savings in the share account will not be available for withdrawal until the loan balance is lower than the savings balance.

Please indicate how you would like to receive the monies

□ Co-operative Bank Account Name ………………………………

Sort Code __ __ __ __ __ __ Account No __ __ __ __ __ __ __ __ __ __

□ BACS: Bank/BS ………………………………… Account Name ………….…………………...

Sort Code __ __ __ __ __ __ Account No __ __ __ __ __ __ __ __ __ __

Financial Details

Please complete the following section to the best of your knowledge.

Income |£ per month (nett) |Expenditure |£ per month |Outstanding Balance |Value of Assets | |Salary/Wages | |Rent/mortgage | | | | |Pension | |Council Tax | | | | |Benefits | |Electricity | | | | |Other (specify) | |Gas | | | | | | |Telephone | | | | | | |Groceries | | | | | | |Catalogues | | | | | | |Credit cards | | | | | | |Hire purchase | | | | | | |Car loan | | | | | | |Other loans | | | | | | |Travel | | | | | | |Clothing | | | | | | |Savings/Investments | | | | | | |Home Insurance | | | | | | |Car insurance | | | | | | |Other (specify) | | | | |TOTAL | |TOTAL | | | | |

If you are subject to any of the following, please tick the relevant box and provide further information:

□ County Court Judgement □ Undischarged Bankrupt □ Mortgage/Loan Arrears

□ Individual Voluntary Arrangement □ Currently on sick/maternity leave

To qualify for a loan all sections must be completed in full. Failure to comply may result in the application being returned to you and delay loan application process. Please note that all loans are subject to approval. Please also supply copies of your last three month’s payslips and bank statements.

Declaration (important – please read carefully)

I declare that

( to the best of my knowledge I am in good health and fit to carry out my normal occupation.

( I am not indebted to any other Credit Union, bank or loan agency as a borrower, guarantor or surety except as stated above.

( neither I nor any company of which I am a shareholder or director is the subject of any bankruptcy or insolvency proceedings or interim or administration order either now or pending or threatened pursuant to the Insolvency Act 1986.

( I have not served or been served notice of termination of my employment.

I further declare the information given on this form is accurate and correct. I understand that the provision of false information is fraud and that in the event I am found to have deliberately falsified information, appropriate action may be taken.

Applicant’s Signature …………………………...……… Date ………………………

Points to note:

• All loans are subject to approval and availability of funds.

• For loans being repaid via payroll deduction, if you leave your employment you MUST inform us prior to your final pay, otherwise any such pay may be taken towards your outstanding loan.

• All loans can be cancelled within 14 days of taking the loan providing all transferred money is returned to the credit union.

• Your personal details will only be used in accordance with the Data Protection Act 1998. They will only be shared with licensed credit reference agencies and for debt recovery purposes, should this be necessary.

Credit Reference and Fraud Prevention Agencies

We may make searches about you at credit reference agencies who will supply us with credit information as well as information from the Electoral Register. The agencies will record details of any search whether or not this application proceeds. We may use credit scoring methods to assist the application and to verify your identity. Credit searches and other information which is provided to us and/or the credit reference agencies about you and anyone with whom you are linked financially or other members of your household may also be used for debt tracing and the prevention of money laundering as well as the management of your account. In addition, we may ask you to provide physical forms of identification and/or we may telephone you to confirm your identity.

To prevent or detect fraud or to assist in verifying your identity we may make searches of group records and at fraud prevention agencies who will supply us with information. We may also pass information to financial and other organisations involved in fraud prevention to protect ourselves and our customers from theft and fraud. If you give us false or inaccurate information, details will be passed to fraud protection agencies. We may use this information if financial or motor, household, credit, life or any other insurance decisions are made about you or others at your address(es). This information may also be used for tracing and claims assessments and verifying identity.

Information held about you by the credit reference agencies may already be linked to records relating to anyone with whom you have a financial relationship such as a joint account.

[pic] Please send the completed form to:

The Co-operative Credit Union

1 Angel Square, MANCHESTER, M60 0AG.

Phone: 0845 6023554

Fax: 0161 332 6172

Email: credit.union@co-operative.coop

www: co-operativecreditunion.coop

11/09

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Loan Application Form

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IMPORTANT NOTICE

In order that we can process your application as

quickly as possible, please fully complete the form

and return to us together with copies of your

last three months payslips and three months bank statements

Registered Office: The Co-operative Family Credit Union Ltd,

1 Angel Square, Manchester, M60 0AG. Reg No 558c.

The Co-operative Family Credit Union Ltd, trading as The Co-operative Credit Union,

is authorised and regulated by the Financial Services Authority. Firm Ref No 213649.

Nov 2009

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