Application for Credit

About Your Self

Amount Requested:*

Purpose:*

Name:*

First Last

Email:*

Address:*

Street Address Address Line 2 City Province Postal Code

SIN:*

DOB:*

Date of Birth

Where Do You Work:*

Employer's address*

Employer's phone number*

Your Position:*

How long have you been there?

Your Monthly Income:

Applicant 2

(Check to add another applicant)

Applicant 2 Info

Applicant 2 Name:*

First Last

Applicant 2 SIN:

Applicant 2 DOB:*

Date of Birth

Applicant 2 - Place of Work:*

Applicant 2 Position:*

Applicant 2 -How long have you been there?

Applicant 2 Monthly Income:

Assets (what you own including any investments, savings, RRSP's, Recreation Vehicles etc.)

Do you own your own residence?:

Yes
No

Residence (Location):

Vehicle 1:

Year, Make, Model

Vehice 1 Amount:

Vehicle 2:

Year, Make, Model

Vehice 2 Amount:

Vehicle 3:

Year, Make, Model

Vehice 3 Amount:

Vehicle 4:

Year, Make, Model

Vehice 4 Amount:

Vehicle 5:

Year, Make, Model

Vehice 5 Amount:

Investments 1:

Investment 1 Amount:

Investment 2:

Investment 2 Amount:

Investment 3:

Investment 3 Amount:

Investment 4:

Investment 4 Amount:

Investment 5:

Investment 5 Amount:

Liabilities: (what you owe)

List company / Financial Institution outstanding and amount

Liability 1:

Liability 1 Amount:

Liability 2:

Liability 2 Amount:

Liability 3:

Liability 3 Amount:

Liability 4:

Liability 4 Amount:

Liability 5:

Liability 5 Amount:

Monthly Rent:

Monthly Heat:

Application Date:

Contact Number (Day):

Format: (###)###-####

Contact Number (Evening):

Format: (###)###-####

Thank you for applying at Citizens Credit Union. Please do not apply at any other financial institutions while we process your application as each application puts a hit on your credit and could decline any approvals we may receive from you. Please Note: At Citizens Credit Union we work hard for our customers to get the best rates possible , Applications take time to process so that we are able to meet the needs and requirements of our customers. Your branch representative will contact you with in 24 hours after you submit your application to tell you the status of your application at that point. By clicking the "Submit Application" button below, you certify that all statements in this application are true and complete and are made for the purpose of obtaining credit. You authorize that Citizens Credit Union to use this application to retain it, to rely on it and to obtain such other information as it may require, including credit reports, to complete the processing of your request for credit.

Acknowledge*

I authorize Citizens Credit Union to review my credit history and have reviewed the above.

Security:

Name

This field is for validation purposes and should be left unchanged.