Willowfield CU | Willowfield Credit Union Members Unsecured Loan Application

PLEASE NOTE: This is a 'MEMBERS ONLY' application form. If you are not a member
you should contact our Administration Office on 028 90455415 or visit our website at Willowfield Credit Union

THIS APPLICATION MUST BE FULLY COMPLETED. FAILURE TO DISCLOSE ALL REQUIRED INFORMATION MAY DELAY THE APPROVAL OF YOUR LOAN APPLICATION.

The Loans Committee may request proof of income. If you are unemployed you may be required to present recent pay slips or current bank statements. If self-employed a copy of your business accounts may be requested

Title *

First Name *

Surname *

Membership Number *

National Insurance Number *

Date of Birth *

Contact phone number (a mobile number if possible) *

House Number or Name *

Address Line 1 *

Address Line 2

Address Line 3

Town *

County *

Postcode *

Residential Status *

What is your marital status? *

Is your spouse or partner a member of Willowfield Credit Union *

Partners membership number (if Yes selected above)

Please provide your employment details *

Job title if employed

Employer’s name

Employer’s Address Line 1

Employer’s Address Line 2

Employer’s Postcode

Total regular income after tax (excluding benefits)£

Pay frequency

Time with present employer (months)

Time with present employer (years)

Please provide details of benefits if applicable and whether paid to you Weekly, 2 Weekly or Monthly

Child Benefit: £

Child Benefit frequency

Income Support: £

Income Support frequency

Working Tax Credit £

Working Tax frequency

Child Tax Credit: £

Child Tax Credit frequency

DLA: £

DLA frequency

Housing Benefit: £

Housing Benefit frequency

Incapacity Benefit :£

Incapacity Benefit frequency

Other £

Other benefits frequency

Please tell us of any other income: (Pension or Housekeeping from family members. Amount, source & frequency)

Pension: £

Pension frequency

Pension source

Other income: £

Other income frequency

Other income source

How many individuals aged 14 years and over live in your house? (Please include yourself) *

How many children aged under 14 years live in your house? *

Mortgage/Rent/Rates

Mortgage/Rent/Rates frequency

Mortgage balance outstanding

Home/Life Assurance

Home/Life Assurance frequency

Food/Electric/heating /phone/TV

Food/Electric/heating /phone/TV frequency

Car/petrol/tax/insurance

Car/petrol/tax/insurance frequency

Child Care

Child care frequency

Credit Cards

Credit Card frequency

Credit card outstanding balance

Other loans

Other loans frequency

Other loans outstanding balance

Which loan type are you applying for?

How much loan required: £ *

Term of credit (in months) *

Repayment Frequency *

What is the loan for? *

Loan repayments can be made at our office or by Standing Order (Please ask for details)

Do you have any County Court Judgements or have you ever been made Bankrupt ? *

To assess your appliction we require you to submit evidence of:
3 months payslip if employed
3 months bank statement
Any other documents to support your application such as proof of benefits, pension statement
These should be uploaded below by either a photo (jpeg) or pdf document

Pay statement 1

Pay statement 2

Pay statement 3

Last 3 months bank statement *

Other supporting document

Please provide you bank account details below. These will be used to pay out your loan and collect payments from

Name of Bank *

Sort Code *

Account number *

Make the following declaration ONLY if you fully understand them

I declare that the statements in this Application form are complete and true to the best of my knowledge and are made for the purposes of obtaining a loan. I understand that Willowfield Credit Union and its representatives may rely on the statements made in this application form in reaching a decision about my Loan application. I understand that if any such statements are subsequently found to be untrue that I will have committed a criminal offence and may be liable to criminal prosecution. I understand that I may be asked to provide further information in support of this application.

I confirm that I am fit to follow my normal occupation or duties *

I understand that I am required to produce photographic ID plus one recent utility bill when collecting my loan if perchance my photographic identity is not held on our computer. *

I declare that the statements in this Application form are complete and true to the best of my knowledge *

Data Protection Act
In accordance with the principles of the Data Protection Act, we will use your personal details for the purposes of managing your account with Willowfield Credit Union. Your personal details will be treated confidentially and will only be shared with other agencies for the purpose of credit referencing and debt recovery.

I hereby authorise Willowfield Credit Union to carry out a Credit Check if required. *

Email *

To complete your application please ensure your Email address is correct and then select Apply below.