Wescom Emergency Loan Application
Insured by NCUA
Loan Amount
Loan Term
Primary Applicant
First Name
Last Name
Social Security Number
-
-
Date of Birth
Address Line 1
Address Line 2
City
State
AL
AK
AZ
AR
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
PR
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Zip Code
Residence Type
Own
Rent
Other
How long have you lived there?
Years
Months
Monthly Housing Expense
Primary Phone
-
-
This is a mobile phone
Work Phone
-
-
Email Address
Employment Type
Employed
Retired
Social Security
Alimony
Disability
Rental Income
IRA/401K
Pension
Unemployed
Other
Employer Name
Occupation
Employment Start Date
Total Monthly Income
Please indicate your hardship below.
Furloughed
Laid Off
Reduction in Hours
Other
Other Hardship Explanation
Click here to add a joint applicant
Joint Applicant
First Name
Last Name
Social Security Number
-
-
Date of Birth
Address Line 1
Address Line 2
City
State
AL
AK
AZ
AR
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
PR
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Zip Code
Residence Type
Own
Rent
Other
How long have you lived there?
Years
Months
Monthly Housing Expense
Primary Phone
-
-
This is a mobile phone
Work Phone
-
-
Email Address
Employment Type
Employed
Retired
Social Security
Alimony
Disability
Rental Income
IRA/401K
Pension
Unemployed
Other
Employer Name
Occupation
Employment Start Date
Total Monthly Income
Please indicate your hardship below.
Furloughed
Laid Off
Reduction in Hours
Other
Other Hardship Explanation
Is there any additional information you'd like to provide?
I certify that everything I have stated in this application and on any attachments is true and correct. I understand and agree that Wescom Credit Union, may retain this application and any other credit information Wescom Credit Union may receive in conjunction with this application whether or not it is approved. By signing below I authorize Wescom Credit Union to gather, review and retain my credit and employment information. I authorize Wescom Credit Union to give information concerning its credit experience with me/us to others. I further authorize Wescom Credit Union to disclose to any other interested parties information as to Wescom Credit Union's experiences or transactions with my account(s). I understand that I must update credit information at Wescom Credit Union's request, or if my financial condition changes. I understand that Wescom Credit Union may report information about my account to credit bureaus. Late payments, missed payments, or other defaults on my account(s) may be reflected in my credit report. I agree that by using or authorizing another to use this account, I will be bound by the terms and conditions of the applicable loan agreement and Truth-in-Lending Disclosure Statement (which will be provided to me if my application is approved and before the first transactions is made). I hereby consent to receive the disclosures related to this application and loan in electronic format. If I wish to obtain a paper copy of the disclosures, I may write to Wescom Credit Union at 123 S. Marengo Avenue, Pasadena, CA 91101, with details of my request. If I request paper copies, they will be provided to me at no charge. If applying for a credit card, I agree to the Credit Card Terms and Conditions and the Truth in Lending Disclosure. In order to access the above-described disclosures, my computer system must meet the following minimum system requirements, which are as follows: I must have an Internet-capable computer with versions 4.0 or higher of Internet Explorer, Netscape Navigator/Communicator, or America Online to view this information. In addition, I must have a printer capable of printing the disclosures. I understand that Wescom Credit Union recommend that I print a copy of any electronically provided disclosures for my records. In the alternative, I must have and maintain the ability to electronically save and visually display the disclosures on my computer screen. I understand and agree that checking the box and executing the "Continue" button below constitutes my electronic signature, and my electronic submission of this application shall be legally binding, such transaction shall be considered authorized by me, and the same terms that apply to a signed paper application will apply to this electronically submitted application. Do you authorize Wescom Credit Union to obtain your credit report and process this loan application?
We certify that everything we have stated in this application and on any attachments is true and correct. We understand and agree that Wescom Credit Union, may retain this application and any other credit information Wescom Credit Union may receive in conjunction with this application whether or not it is approved. By signing below we authorize Wescom Credit Union to gather, review and retain our credit and employment information. We authorize Wescom Credit Union to give information concerning its credit experience with us to others. We further authorize Wescom Credit Union to disclose to any other interested parties information as to Wescom Credit Union's experiences or transactions with our account(s). We understand that we must update credit information at Wescom Credit Union's request, or if our financial condition changes. We understand that Wescom Credit Union may report information about our account to credit bureaus. Late payments, missed payments, or other defaults on our account(s) may be reflected in our credit report. We agree that by using or authorizing another to use this account, we will be bound by the terms and conditions of the applicable loan agreement and Truth-in-Lending Disclosure Statement (which will be provided to us if our application is approved and before the first transactions is made). We hereby consent to receive the disclosures related to this application and loan in electronic format. If we wish to obtain a paper copy of the disclosures, we may write to Wescom Credit Union at 123 S. Marengo Avenue, Pasadena, CA 91101, with details of our request. If we request paper copies, they will be provided to us at no charge. If applying for a credit card, we agree to the Credit Card Terms and Conditions and the Truth in Lending Disclosure. In order to access the above-described disclosures, our computer system must meet the following minimum system requirements, which are as follows: we must have an Internet-capable computer with versions 4.0 or higher of Internet Explorer, Netscape Navigator/Communicator, or America Online to view this information. In addition, we must have a printer capable of printing the disclosures. We understand that Wescom Credit Union recommend that we print a copy of any electronically provided disclosures for our records. In the alternative, we must have and maintain the ability to electronically save and visually display the disclosures on my computer screen. We understand and agree that checking the box and executing the "Continue" button below constitutes our electronic signature, and our electronic submission of this application shall be legally binding, such transaction shall be considered authorized by us, and the same terms that apply to a signed paper application will apply to this electronically submitted application. Do you authorize Wescom Credit Union to obtain your credit report and process this loan application?
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