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Federally Insured by NCUA
We are an Equal
Housing Lender
(click image above
to view notice)
Note:
All fields with an asterisk(*) indicate required fields that must be completed before submitting your application.
For security, this page will time-out in 20-minutes if no submission is performed.
Please report any issues with this application to LOpipare@yourfederalcu.com
Primary Applicant
Application Type
Purchase
Home Equity
Home Improvement
Refinance
First Name
*
Last Name
*
Date of Birth
*
(MM/DD/YYYY)
Social Security Number
*
(Last 4-digits)
Present Address
*
City
*
State
*
ZIP Code
*
Home Phone
*
(Numbers Only with Area Code)
Cell Phone
(Numbers Only with Area Code)
Years at present address
*
Home Owner's Association
Yes |
No
Employer Name
*
Business Phone
*
(Number Only with Area Code)
Job Title
Years at present employer
*
Gross Monthly Income
*
$
(Number Only)
Cash / Deposits
401K / IRAs
Purpose of funds
(if Home Equity)
If for debt consolidation,
what debts will be paid?
Amount to borrow
*
$
(Number Only)
Mortgage Type
N/A
First Mortgage
Second Mortgage
Term
*
(in months)
Your Email Address
Government Monitoring
For government monitoring purposes we are required to ask you for your ethnicity, race, and sex. The federal government requests this information in order to monitor compliance with federal statutes that prohibit lenders from discrimination against applicants on these bases. You are not required to furnish this information, but are encouraged to do so.
I do not wish to furnish this information
Sex:
Male
Female
Ethnicity:
Hispanic or Latino
Not Hispanic/Latino
Race:
American Indian or Alaska Native
Asian
Black or African American
Native American
Other Pacific Islander
White
By clicking "Yes" directly below, my intent is to apply for joint credit with the secondary applicant listed on this application.
Do you intend to apply for joint credit?
*
Yes |
No
(Clicking Yes requires Secondary Applicant information to be completed below)
Secondary Applicant
Relationship to Primary Applicant
*
First Name
*
Last Name
*
Date of Birth
*
(MM/DD/YYYY)
Social Security Number
*
(Last 4-digits)
Present Address
(if different from primary applicant)
City
State
ZIP Code
Home Phone
(Numbers Only with Area Code)
Cell Phone
(Numbers Only with Area Code)
Years at present address
Employer Name
*
Business Phone
*
(Number Only with Area Code)
Job Title
Years at present employer
*
Years in this same line of work
Gross Monthly Income
*
$
(Number Only)
Government Monitoring
For government monitoring purposes we are required to ask you for your ethnicity, race, and sex. The federal government requests this information in order to monitor compliance with federal statutes that prohibit lenders from discrimination against applicants on these bases. You are not required to furnish this information, but are encouraged to do so.
I do not wish to furnish this information
Sex:
Male
Female
Ethnicity:
Hispanic or Latino
Not Hispanic/Latino
Race:
American Indian or Alaska Native
Asian
Black or African American
Native American
Other Pacific Islander
White
By checking "Yes" directly below, my intent is to apply for joint credit with the primary applicant listed on this application.
Do you intend to apply for joint credit?
*
Yes |
No
