Secure Loan Application and Information

Are you a Member of Rockland Federal Credit Union?

	Yes, I am a member of Rockland Federal Credit Union
	I am not a member, but I live in Barnstable, Bristol, Middlesex, Norfolk, Plymouth or Suffolk Counties
	I am not a member, but I work in Barnstable, Bristol, Middlesex, Norfolk, Plymouth or Suffolk Counties Employer City:
	I am an immediate family member of an eligible or current member

If you are not currently a member of RFCU, and qualify to be a member, you will be required to open a $5.00 savings or checking account prior to or at the closing of your loan. You are welcome to apply for a loan now. To open an account and join Rockland Federal Credit Union please go to the Membership section on our Home Page for more information.

To apply, submit the secure online application below.

What Kind of Loan?

Bi-Weekly Loans are not available.
NOT FOR POST-SECONDARY EDUCATION

If Auto Loan:

Year	Make
Model (Example: F150 XLT, power seats, leather, etc.)	Mileage *If new, type "new"

How many applicants?

Individual Joint

* Amount Requested?

Loan Term?

If you are refinancing an auto loan please provide us with your current lender's name and your loan account number in the space below.

* Reason?

(pre-approval, purchase, refinance)

Application Information

All fields with an asterisk (*) indicate required fields that must be completed before submitting your application

* First Name
Middle Initial
* Last Name
* Date of Birth (MM/DD/YYYY)		/ /
* Social Security Number
* Work Phone Number
* Home Phone Number
* E-mail Address
* Residential Address
* City
* State
* Zip Code
Mailing Address If different
City
State
Zip Code
* Years at Current Address
* Residential Status		Own Rent With Family Other
* Rent or Mortgage Payment
* Are you currently Employed?		Yes No
* Employer's Name
* Job Title or Occupation
* Years at Current Employer
* Gross Annual Salary
* Are You a U.S. Citizen?		Yes No
Other Source of Income
Alimony, child support or separate maintenance income need not be revealed if you do not wish to have it considered as a basis for repayment of this loan.
Description
Gross Annual Amount
Joint Applicant Information
If this loan application is a joint request for credit, the co-applicant must indicate by checking the Yes box below, that it is his/her intent to be a co-applicant and the information provided will be used on this credit request. Yes No*
*	First Name
	Middle Initial
*	Last Name
*	Date of Birth (MM/DD/YYYY)	/ /
*	Social Security Number
* Work Phone Number
* Home Phone Number
*	E-mail Address
*	Residential Address
*	City
*	State
*	Zip Code
Mailing Address If different
City
State
Zip Code
*	Years at Current Address
*	Residential Status	Own Rent With Family Other
*	Rent or Mortgage Payment
*	Are you currently Employed?	Yes No
*	Employer's Name
*	Job Title or Occupation
*	Years at Current Employer
*	Gross Annual Salary
* Are You a U.S. Citizen?		Yes No
	Other Source of Income
	Alimony, child support or separate maintenance income need not be revealed if you do not wish to have it considered as a basis for repayment of this loan.
	Description
	Gross Annual Amount

Comments/Other Information

Other information may be required to complete your application, including income verification. Please note that we may report information about your account to credit bureaus. Late payments, missed payments, or other defaults on your account may be reflected in your credit report.
By clicking "Submit" below:
I/we promise all information given on this application is correct to the best of my/our knowledge.
And
I/we authorize Rockland Federal Credit Union to check my/our credit and employment history and to answer questions about your credit experence with me/us.
The information you send to RFCU on this form will be encrypted for your privacy and protection

Privacy and Security Statement

To Be Completed At Time of Closing

Signature of Applicant(s)
All joint applicants must sign.
Everything that I/We have stated in this application is correct to the best of my/our knowledge. I/We understand that you will retain this application whether or not it is approved. You are authorized to check my/our credit and employment history and to answer questions about your credit experience with me/us.

We intend to apply for joint credit		___________________ APPLICANT INITIALS	_____________________ CO-APPLICANT INITIALS

_________________________________________
_________________________________________
Signature of Applicant	Date	Signature of Co-Applicant	Date