Charleston Postal Employees Credit Union
1000 Centre Way, Room 3-47
Charleston, West Virginia 25309

Telephone: (304) 746-5111
Fax: (304) 746-5112

(Applicant start here:)
For: Charleston Postal Employees Credit Union Members Only

Information regarding:Applicant Additional Party ...........Date _______________________
Name________________________________________Account________________________
We hereby apply for a loan as follows: (** to be completed by applicant)

Amount of money requested .. .......................$ ____________
Old loan balance (if any).................................$_____________
Accrued finance charge (interest date).............$ ____________
Other charges.................................................$_____________
Total new loan...........................................................................$_____________
To be repaid in ** ________payments of........$_____________
Including/plus interest starting on___________________________________________________
Purpose of loan**______________________________________________________________

Individual Credit: (Do NOT complete marital status for INDIVIDUAL credit in non-community property state.)
Applicant's signature only
Endorser, guarantor or surety (Co-signer)
Name __________________________________________________
(Have this person complete a separate loan application.)

Joint Credit - Joint Applicant or Co-Maker (person who will be equally liable for repayment)

Name_____________________________________________________________________
(Have this person complete a separate loan application.)
Relationship to applicant, if any __________________________________________________

Secured Credit - Collateral
Shares in Account Nos.__________________________________________$______________
New/Used Auto-Make________________Year_____________ Cost/Value $______________
Other_______________________________________________________________________
Owners'Name_________________________________________________________________

MARITAL STATUS: Complete marital status if this loan is for:
a. Joint or secured credit, or
b. You reside in or rely on property located in a Community Property State
(AZ, CA, ID, LA, NM, NV, TX,WA)
Unmarried Married Separated

Full Name ____________________________Birth Date________ SS No. __________________
Street Address________________________________________Years there_________________
City_____________________________________________State_______ZipCode____________
Home Phone_____________ Business Phone__________Present Employer___________________
Years there _____ Position or Title________________Supervisor___________________________
Employer's Address_______________________________________________________________
City____________________________________________State_________ Zip Code __________
Dependents (exclude self)________________________________________Ages_______________
*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.
Salary (Gross Net)$______________Per______
*Other Income_____________________Per_______________Source_____________________
Is any income listed likely to be reduced before this loan is paid off? No Yes
If yes, explain___________________________________________________________________
If present residence less than 2 years, complete the next 2 lines
Previous Street Address__________________________________________Years there________
City_______________________________________State___________Zip Code_____________
If employed by above less than 3 years, complet next 2 lines
Previous Employer________________________________________________Years there______
Previous Employer's Address_______________________________________________________

Are there any other persons on any of the above loans? No Yes
(Which ones and who?)______________________________________________________
Are you a co-maker, co-signer or guarantor on any other loan with this credit union? No Yes
For Whom?_______________________________________________
Have you been declared bankrupt in the last 14 years? No Yes

Everything that I have stated in this application is correct to the best of my knowledge. You are authorized to check my credit card and employment history and to answer question about your credit experience with me.
Signature of Member___________________________________________Date_____________

Credit Committee: Date:_____________________________________________________
We approve the loan as submitted.
We reject the loan as submitted.
The following counter offer will be made to the applicant and if accepted, we approve the loan. Describe____________________________________________________________________
___________________________________________________________________________
Specific reason(s) for rejection____________________________________________________
Outside information considered No Yes(describe______________________________________________________________________
_____________________________________________________________________________
Signed__________________________________________________Date___________________
Signed__________________________________________________Date___________________
Signed__________________________________________________Date___________________