Loan Application

Please Note: You must be a member or qualify for membership to be eligible for extension of credit. Additionally, any loans where real estate is used as collateral, the property must be located in the state of Vermont.

Individual Credit: You must complete the Applicant section about yourself and the Other section about your spouse if:

  1. you live in or the property pledged as collateral is located in a community property state,
  2. your spouse will use the account, or
  3. you are relying on your spouse's income as a basis for loan repayment. If you are relying on income from alimony, child support, or separate maintenance, complete the Other section to the extent possible about the person on whose payments you are relying.

Joint Credit: Each Applicant must individually complete the appropriate section below. If Co-Borrower is spouse of the Applicant, mark the Co-Applicant box.

Guarantor: Complete the Other section if you are a guarantor on an account loan.

Important Information About Procedures for Opening a New Account
To help the government fight the funding of terrorism and money laundering activities, Federal law requires all financial institutions to obtain, verify, and record information that identifies each person and/or entity who opens an account.

What this means to you: When you open an account, we will ask for your name, address, date of birth (for individuals) and other information that will allow us to identify you. We may also ask to see your driver's license or other identifying documents.


Loan Information

Personal Loan Application Account Type *
  1. If you have a spouse or registered domestic partner ("RDP")*, your spouse or RDP should not sign this application unless he/she wishes to be obligated in this Loan as a Co-Borrower. If you have a spouse/RDP, you may still apply for individual credit. However, if you live in a community property state (AZ, CA, ID, LA, NM, NV, TX, WA, WI), you are encouraged to consult with your own financial or legal advisor to ascertain whether community property assets may be at risk in the event of default.
  2. If you are under 21 years of age, and are applying for a credit card, you must either:
    1. Provide proof of your ability to make the required payments; or
    2. Complete the Co-Applicant section and obtain the signature of a co-signer or joint applicant who is at least 21 years of age and has the means to repay the debt and agrees to joint liability

* Refers to RDP's in a state with RDP laws that provide for community property rights that mirror those of a spouse.

Type of Loan *
Payment Method *

If you answer "yes", the credit union will disclose the cost to protect your loan. The protection is voluntary and does not affect your loan approval. In order for your loan to be covered, you will need to sign a separate application that explains the terms and conditions.

Primary Applicant

Personal Information

Applicant Personal Information
Applicant's Phone Number(s)

Please provide at least one phone number

Marital Status

Complete for joint credit, secured credit, or if you live in a community property state.

Current Residence

Applicant Current Residence
Do you own or rent? *

Previous Residence (If less than five (5) years ago)

Applicant Previous Residence (If less than five (5) years ago)
Did you own or rent?

Employment & Income

Applicant Employment & Income
Gross or net

NOTICE: Alimony, child support, or separate maintenance income need not be revealed if you do not choose to have it considered.

Previous Employer (If employed less than five years)

Applicant Previous Employer


Applicant Reference

Current Debts



Asset 1 Collateral
Asset 2 Collateral
Asset 3 Collateral

Additional Information

If you answer "YES" to any question other than #1, please explain.

1. Are you a U.S. citizen or permanent resident alien?

2. Do you currently have any outstanding judgements or have you ever filed for bankruptcy, had a debt adjustment plan confirmed under Chapter 13, had property foreclosed upon or repossessed in the last 7 years, or been a party in a lawsuit?

3. Is your income likely to decline in the next two years?

4. Are you a co-maker, co-signer or guarantor on any loan not listed above?

Additional Notes and Information

Please provide any additional information that may be important to processing your application.


You promise that everything you have stated in this application is correct to the best of your knowledge and that the above information is a complete listing of what you owe. If there are any important changes, you will notify us in writing immediately. You authorize the Credit Union to obtain credit reports in connection with this application for credit and for any update, increase, renewal, extension, or collection of the credit received. You understand that the Credit Union will rely on the information in this application and your credit report to make its decision. 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. It is a federal crime to willfully and deliberately provide incomplete or incorrect information on loan applications made to federal credit unions or state chartered credit unions insured by NCUA.

Typing your name(s) into the signature field(s) below will constitute an electronic signature.

Primary Applicant Signature and Date

Please review your application carefully and verify all information is accurate before submitting.

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