Everest FCU Auto Loan Application

Amount Requested*

Type of Loan*

Personal Information

First Name*

Last Name*

Account Number*

Home Phone*

No dashes, spaces, or parentheses

Cell Phone*

No dashes, spaces, or parentheses

Social Security No.*

No dashes, spaces, or parentheses

Email*

Address *

City *

State *

Zip Code *

Date of Birth *

Reference Name*

Phone *

No dashes, spaces, or parentheses

Vehicle Information

Make*

Model*

Year*

Dealer / Seller Name*

Contact Phone*

No dashes, spaces, or parentheses

Address*

Email*

Monthly Income and Housing Expenses

Employer*

Address *

City *

State *

Zip Code *

Employee Start Date *

Phone*

No dashes, spaces, or parentheses

Monthly Salary *

Annual Income Per

Self-employment NET Income*

Other source(s) of income, including SSI, SSA, welfare, investments, snap

Other Income

Total Monthly Income

Monthly Mortgage/Rent Payment (includes taxes and insurance)

Credit History

Do you have active credit card or loans?*

If yes, what is your total monthly debt payment?

Have you ever declared backruptcy and / or been evicted?*

If yes, please explain

Applicant's Signature

All statements made above are true and complete and submitted for the purpose of obtaining Credit. In considering this application Everest Federal Credit Union may contact my personal references, employer and evaluate reports from outside credit reporting agencies. I may request to know whether the credit union obtained such reports, and if so, from whom.

Signature (type your full name) *

Date *