European Home Secured Loan


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Please provide all the requested information. When you have completed the form, press the Submit button to send your application.

A Mortgage Representative will contact you to review your request. Please indicate how you would like us to contact you.

	Email Address
	Home Telephone Number
	Work Telephone Number

Type of mortgage loan requested (Please select one type of loan per application)
Mortgage loan requested
Amount requested - US $
Term of the home loan	Years
Purpose of home loan	Refinance Purchase

If you have chosen 'Refinance' please fill out this section. If you have chosen 'Purchase' please skip this section and go directly to the subject property address.

	Refinancing:
	Year existing loan was acquired
	Amount of Existing liens US $
	Purpose of Refinance
	Name of current Lender

Subject Property Address
(Please indicate the address of the new or existing property that this home loan would finance.)

Address 1
Address 2
City
Country
Type of Property

Will there be a joint applicant on this mortgage loan application?
Yes or No

Primary Applicant

Member Number

Last Name

First Name

Social Security Number

(Type 'NA' if non-applicable)

Date of Birth

Year

Present Address 1

Present Address 2

City

State/Province

(Please enter N/A if non-applicable)

Zip/Postal Code

Country

Type of Residence

Own Rent Live with Relatives

OR

Other (please specify)
Time at Current Residence	years
Home Telephone Number
Fax Number

Agency/Employer Name

Employer Address

Employer Phone Number

Job Start Date

Month/Year

Gross Income US $

Annual

Net Income US $

Monthly

Job Title/Grade

Contract Expiration Date

Month/Year

Joint Applicant (if applicable)

Member Number
Last Name
First Name
Social Security Number
Date of Birth	Year
Present Address 1
Present Address 2
City
State/Province	(Please enter N/A if non-applicable)
Zip/Postal Code
Country
Home Telephone Number
Fax Number	(Please enter N/A if non-applicable)
Agency/Employer Name
Employer Address
Employer Telephone Number
Job Start Date	Month/Year
Gross Income US $	Annual
Net Income US $	Monthly
Job Title/Grade
Contract Expiration Date	Month/Year

Fill in the monthly payment, balance due and creditor for each debt that you have. If any of the debts listed below do NOT apply to your situation, simply check the 'NA' box and then move to the next debt or section.
	NA	Debt Type	Montly Payment	Balance Due	Creditor/Bank Name
		Rent or Mortgage
		Auto Payment/Lease
		Auto Maintenance Amount
		Credit Card Payment
		Credit Card Payment 2

Other Debts/Monthly Payments:
Please use this space to detail any other debts or payments that you have, that were not listed above. Be sure to complete all of the fields for each debt that you have. If you have no other debts please proceed to the next section.

Debts	Monthly Payment	Balance Due	Creditor Bank Name

Assets Please list all of the assets that you have using the fields below. Be sure to complete all of the fields for each asset that you have. If you have no assets please proceed to the next section.
Asset Type (Home, Vehicle, Bank Accounts, Stocks, Bonds, etc.)	Creditor / Bank	Value
		US$
		US$
		US$
		US$
		US$

Please note: Income verification and property valuation is required. Other information may be required.

I certify that statements on this application are true and complete. I authorize any person,association, firm or corporation to furnish, on request of this Credit Union, information concerning me or my affairs. (Sec. 1014, Title 13, U.S. Code, makes it a Federal Crime to knowingly make a false statement on this application of a Federal Credit Union.)