Willowfield CU | Willowfield Credit Union Members Secured Loan Application

PLEASE NOTE: This is a 'MEMBERS ONLY' secured loan 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This is a secure loan application where your shares are held as security against the loan and cannot be withdrawn. If you want a standard loan please use this form

Title *

First Name *

Surname *

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 *

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 ? *

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 confirm, this is a secure loan application and my shares are held as security against the loan *

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.

Email *

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