LOAN APPLICATION Individual Credit: You must complete the Applicant section about yourself and the Other section about your spouse if: 1. you live in or the property pledged as collateral is located in a community property state (AK, AZ, CA, ID, LA, NM, NV, TX, WA, WI), 2. your spouse will use the account, or 3. you are relying on your spouse's income as a basis for repayment. If you are relying on income from alimony, child support, or separate maintenance, complete the Other section to the extent possible about the person on whose payments you are relying. Joint Credit: If you are applying with another person, complete the Applicant and Other sections. Guarantor: Complete the Other section if you are a guarantor on an account/loan. Are you related to any CTFCU employee, Board Member or Committee Member? Yes_______ No________ Check below to indicate the type of account(s) and type of credit for which you are applying. Married applications may apply for a separate account LOANLINER® Account/Loan:     Individual   Joint   Amount Requested $____________ Purpose/Collateral:_____________________ (Including ATM/Debit Card access to the account if Available) Payment Protection Single Credit Disability Insurance  Single Credit Life Insurance  Joint Credit Life Insurance  Check coverage(s) desired. The credit union will disclose the cost of this voluntary insurance to you. A separate insurance election which discloses the terms and conditions must be signed for coverage to become effective. Applicant  NAME (last - first - Initial)  MOTHER'S MAIDEN NAME  ACCOUNT NUMBER  SOCIAL SECURITY NUMBER  DRIVER'S LICENSE NUMBER / STATE EMAIL ADDRESS BIRTH DATE HOME PHONE BUSINESS PHONE / EXT.   (     ) (     ) PRESENT ADDRESS (Street - City - State - Zip) OWN   RENT     YEARS AT THIS ADDRESS  MORTGAGE/RENT OWED TO: MORTGAGE BALANCE $ __________________ MONTHLY PAYMENT $ _________________ INTEREST RATE _______________% COMPLETE FOR JOINT CREDIT, SECURED CREDIT OR IF YOU LIVE IN A COMMUNITY PROPERTY STATE: MARRIED SEPARATED UNMARRIED (Single - Divorced - Widowed) START DATE       EMPLOYMENT/INCOME      NAME AND ADDRESS OF EMPLOYER NOTICE:  : ALIMONY CHILD SUPPORT, OR SEPARATE MAINTENANCE INCOME NEED NOT BE REVEALED IF YOU DO NOT CHOOSE TO HAVE IT CONSIDERED EMPLOYMENT INCOME OTHER INCOME $_______________ PER_______________ $_______________ PER_______________ NET GROSS   SOURCE______________________________ Other  Co-Applicant  Spouse  Guarantor  NAME (last - first - Initial)  MOTHER'S MAIDEN NAME  ACCOUNT NUMBER  SOCIAL SECURITY NUMBER  DRIVER'S LICENSE NUMBER / STATE EMAIL ADDRESS BIRTH DATE HOME PHONE BUSINESS PHONE / EXT.   (     ) (     ) PRESENT ADDRESS (Street - City - State - Zip) OWN   RENT     YEARS AT THIS ADDRESS  MORTGAGE/RENT OWED TO: MORTGAGE BALANCE $ __________________ MONTHLY PAYMENT $ _________________ INTEREST RATE _______________% COMPLETE FOR JOINT CREDIT, SECURED CREDIT OR IF YOU LIVE IN A COMMUNITY PROPERTY STATE: MARRIED SEPARATED UNMARRIED (Single - Divorced - Widowed) START DATE       EMPLOYMENT/INCOME      NAME AND ADDRESS OF EMPLOYER NOTICE:  : ALIMONY CHILD SUPPORT, OR SEPARATE MAINTENANCE INCOME NEED NOT BE REVEALED IF YOU DO NOT CHOOSE TO HAVE IT CONSIDERED EMPLOYMENT INCOME OTHER INCOME $_______________ PER_______________ $_______________ PER_______________ NET GROSS   SOURCE______________________________ STATE LAW NOTICES OHIO RESIDENTS ONLY: The Ohio laws against discrimination require that all creditors make credit equally available to all creditworthy customers, and that credit reporting agencies maintain separate credit histories on each individual upon request. The Ohio Civil Rights Commission administers compliance with this law. WISCONSIN RESIDENTS ONLY:(1) No provision of any marital property agreement, unilateral statement under Section 766.59, or court decree under 766.70 will adversely affect the rights of the Credit Union unless the Credit Unions furnished a copy of the agreement, statement or decree, or has actual knowledge of its terms, before the credit is granted or the account is opened. (2) Please sign if you are not applying for this account or loan with your spouse. The credit being applied for, if granted, will be incurred in the interest of the marriage or family of the undersigned. X_______________________________________________________________________________ SIGNATURE FOR WISCONSIN RESIDENTS ONLY                               Date Signatures You promise that everything you have stated in this application is correct to the best of your knowledge. If there are any important changes you will notify use in writing immediately. You authorize the Credit Union to obtain credit reports in connection with this application for credit and any update, increase, renewal or extension of the credit received. You understand that the Credit Union will rely on the information in this application and your credit report to make its decision. If you request, the Credit Union will tell you the name and address of any credit bureau from which it received a credit report on you. It is a federal crime to willfully and deliberately provide incomplete or incorrect information on loan applications made to federal credit unions or state chartered credit unions insured by NCUA. X __________________________________________ X __________________________________________   Applicants Signature                                 Date   Other Signature                                 Date You Must Print, Sign, and Mail or Fax to Credit Union: Catoosa Teachers FCU 25 Gateway Business Park Drive Ringgold, GA 30736 706-965-6166 (Fax)