Please Complete All Sections As Incomplete Forms Will Not Be Considered

MEMBERSHIP Cambuslang Credit Union Limited LOAN NUMBER NUMBER At the heart of our Community / Serving you in G72 PERSONAL LOAN APPLICATION PLEASE COMPLETE ALL SECTIONS AS INCOMPLETE FORMS WILL NOT BE CONSIDERED

TITLE: HOME TELEPHONE: NAME: CURRENT MOBILE: YOUR EMAIL: ADDRESS: LIVING STATUS: (PLEASE TICK AT YOUR STATUS) TENANT HOMEOWNER STAY IN DIGS STAY WITH FAMILY POSTCODE: N.I. NUMBER IF LESS THAN 2 YEARS PLEASE GIVE PREVIOUS ADDRESS:- ADDRESS: UP TO DATE PROOF OF RECEIVED: ADDRESS MUST BE POSTCODE: EXHIBITED PRIOR TO LOAN AWAITED: FUNDS BEING RELEASED

Weekly Income £ p Wages (After Tax) Rent/Digs/Mortgage Pension(s) Council Tax Jobseekers Allowance Gas & Electricity Disability Allowance Mobile/Landline Working Tax Credit Insurance(s) Family Tax Credit Sky/BT/Freeview Child Benefit TV Licence Family Income (Digs etc) Travel Costs/Petrol Student Grant Credit Union Payments Maintenance Other Loans/HP/Finance Other Income (Specify) Housekeeping Total £ APPLICANTS FINANCIAL INFORMATION – Submitted information is solely for CCU use CURRENT EMPLOYMENT DETAILS – PLEASE TICK EMPLOYMENT Full Time Employers Details: ______Part Time ______Self Employed ______Works Phone No. ______PLEASE TICK: - RETIRED UNEMPLOYED STUDENT OTHER SHARE ‘2’ £ BALANCE OF YOUR £ ‘XMAS SHARE ‘1’ ACCOUNT £ SAVER’ LOAN PURPOSE: LOAN AMOUNT INTEREST FIRST LOAN REQUESTED: £ CHARGED £ YES / NO CURRENT LOAN REPAYMENT WEEKLY BALANCE: £ FREQUENCY FORTNIGHTLY

TOTAL (PLEASE TICK 4 WEEKLY OUTSTANDI £ YOUR OPTION) NG MONTHLY

THE REPAYMENT IS BY WAY OF ______INSTALMENTS OF £ ______AND I ALSO AGREE TO SAVE £______THE FIRST REPAYMENT DATE IS ____/____/______LOAN REPAYMENT BY STANDING ORDER: YES/NO MY HOLIDAY DATES ARE: –

DETAILS OF CONTACT PERSON NOT STAYING AT SAME ADDRESS AS APPLICANT: - NAME: RELATIONSHIP TO APPLICANT:

ADDRESS: PHONE NUMBER(S):

PERSONAL HEALTH DECLARATION I DECLARE TO THE BEST OF MY KNOWLEDGE THAT I AM CURRENTLY:- IN GOOD HEALTH NOT IN GOOD HEALTH FINANCIAL DECLARATION - I STATE THAT I HAVE FULLY DECLARED, TO THE BEST OF MY ABILITY, ALL INCOME & EXPENDITURE INCLUDING ANY LOANS FROM & GUARANTEES TO OTHER FINANCIAL INSTITUTIONS. I AGREE TO A CREDIT CHECK IF REQUIRED BY CCU (APPLICABLE FOR ALL FIRST LOANS)

APPLICANT’S SIGNATURE: ______DATED ___/___/______

AUTHORISED SIGNATURE: ______DATED ___/___/______

FOR CREDIT COMMITTEE USE: - LOAN AMOUNT APPROVED £______LOAN NUMBER ______/_____

FOR A PERIOD OF ______AT £ ______

SIGNED ______SIGNED ______

DATED ____/____/______DATED ____/____/______(Revised 08/15)