Online Loan Application

You must be a member of Larkhill & District Credit Union to be eligible for a loan. Terms and conditions apply.

ALL LOANS THAT ARE ABOVE SHARES WILL REQUIRE AN ICB CREDIT CHECK. THIS ONLINE APPLICATION WILL REQUIRE YOU TO COMPLETE THIS FIELD. IF NOT COMPLETED IT MAY LEAD TO A DELAY IN YOUR APPLICATION BEING ASSESSED.

Please complete all your details in the form below, and click submit when you have finished.

Online Loan Application

* Required Fields
Account Number:	*
Member Name:	*
Member Address:	*
Previous Address (If less than 3 years):
Type of Accommodation:	Please Choose...OwnerTenantLiving with ParentsOther  *
If Other, please specify:
Tel Home:	*
Tel Work:
E-mail Address:	*
Date of Birth:	*
Marital Status:	Please Choose...SingleMarriedSeparatedDivorcedEngaged  *
Number of Dependants:

Employment Details

* Required Fields
Employer:	*
Work Address:	*
Occupation:	*
Length of Service:	*
Weekly Salary:	€   *
Other Income:	€
Payroll Number:

Spouse/Partners Details (where relevant)

* Required Fields
Spouse/Partners Name:
Spouse/Partners Employer:
Employers Address:
Spouse/Partners Occupation:
Spouse/Partners Weekly Income:	€
Any Other Income:	€
Spouse/Partners Date of Birth:

Current Financial Situation

* Required Fields
I declare that I am indebted to the following:
	Original Amount Balance Outstanding Monthly Repayment Amount
Bank/Building Society:	€ € €
Rent/Mortgage:	€ € €
Credit Card:	€ € €
Other:	€ € €
Previous Credit Union Loans
	Amount Date Repayment Amounts Repayment Frequency
1:
2:
3:
Current Savings Balance(s):	€   *
Current Loan Balance(s):	€
Current Arrears:	€

Loan Details

* Required Fields
I wish to apply for a loan of:	€   *
Pupose of Loan:	*
Date Required:	*
To be repaid every:	Please Choose...WeekFortnight4-WeeksMonth  *
In installments of:	€   *

Declaration

* Required Fields
I declare that I am not indebted to any other Credit Union, Bank or Loan Agency either as a borrower or Guarantor, except as stated on this application. The statements herein are made for the purposes of obtaining the loan and are true to the best of my knowlewdge and belief.
I declare that to the best of my knowledge: * I am in good health I am NOT in good health
And that: * I am fit to follow my normal occupation I am NOT fit to follow my normal occupation
Signature of Applicant:	*
Date Signed:	*
Data Protection Act 1988 - I consent to the information contained in this application form being used by the Credit Union for the purposes of processing my application