» Effective April 1, 2015, there will be a $10.00 processing fee assessed on all loan applications.
Submitting this application online allows Rose City FCU to debit your account for this fee.
ROSE CITY FEDERAL CREDIT UNION

P.O. Box 2741, Thomasville, GA 31799
Lending Center 229-584-1082 / Toll Free 866-389-7673 / Fax to 229-584-1090
APPLICATION FOR LOAN
(This application should be hand delivered, mailed or faxed to the credit union)

Member # sub # Joint application? (Check if Yes)
(Co-applicant must complete separate application)
Name: SS#
Address: City: State: Zip:
Home Phone: Work Phone: Birthdate: mm/dd/yyyy
Purpose of Loan:

( Check one ) Refinance ? New Loan ? Payroll ? Manual Payments ? Sharedraft ?
Dollar Amount Requested:
Employer: Title:
Hire Date: Mo. Income: Other Income:
Source:
Previous Employment:
Name and address of nearest relative:
Relationship: Home Phone: Work Phone:
Collateral description:

DEBTS
I am indebted to the following creditors: Please list all secured and unsecured debts.
Individual
or Joint
Creditor Name: Orig Loan Amount Balance Owed Payment Amount Pastdue? Check if yes

List any other names you have gained credit under:

Are you a co-maker or guarantor on any other loan?
(Check if yes) For who:
Do you have any Judgements, Garnishments, or Legal Proceedings against you?
(Check if yes) If yes, Where?
Have you ever filed Bankruptcy?
(Check if yes) Type: Year:

I hereby certify that all statements made are true and complete and submitted for the purpose of obtaining credit. I have no other debts. The credit union is authorized to check my credit and employment history and to answer questions about its credit experience with me.
Authorized Signature: Date:
( Pringing Instructions: Portrait, all borders = 0.5" )


FOR CREDIT UNION USE ONLY:

Date: Approved Limits Unsecured $ Line of credit $
Other Secured $ Debt Ratio:
Advance Approved: Yes No Loan Officer: #
Committee: Yes No Counter Officer:
If accepted, advance approved.
1. 2.
3. 4.
Outside information considered: Yes No If Yes, attach additional sheet and describe
Specific Reason for Rejection:


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