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This institution is federally insured by the National Credit Union Administration  
Federally Insured by NCUA
We are an Equal Housing Lender


  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
  • Submission of this request, authorizes YOUR Federal Credit Union to obtain credit information from a credit reporting agency
  • To help the government fight the funding of terrorism and money laundering activities, Federal law requires all financial institutions to obtain, verify, and record information that identifies each person who opens an account. What this means for you: When you open an account, we will ask for your name, address, date of birth, and other information that will allow us to identify you. We may also ask to see your driver's license or other identifying documents.

  Primary Applicant
Application Type
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
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

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