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Loan Application

Please complete all requested information and submit the form using the button at the bottom of the page. We will contact you regarding the status of your application.

* - Indicates required field

Loan Type

$
Type of Credit

Payment Protection Coverage

Check coverage(s) desired.  We will disclose the cost of this Payment Protection Insurance to you.  A separate form which discloses the terms and conditions must be signed for coverage to become effective. For more information about TruStage Debt Protection and GAP coverage, click here.

Would you like to add optional TruStageā„¢ Debt Protection to this loan to help protect your loan if covered life events occur?
Do you want your auto loan protected by Guaranteed Asset Protection insurance (GAP)?

Primary Applicant

Personal Information

$
Type of Housing

Employment/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 repaying this obligation.


Joint Applicant

Personal Information

$
Type of Housing

Employment/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 repaying this obligation.


Reference

Nearest Relative Not Living With You


Proof of Income Verification

Proof of Income from all sources is required prior to loan approval. This can be through your previous year’s W2 or your two most recent pay stubs. You may submit your proof of income in person to any office, or by fax to the Main Office at 1-855-735-8331 or Williamsport at 1-844-734-2812, or by uploading the files below.


Additional Information

How would you prefer to be contacted?



If approved, where would you like to sign loan documents?



Application Submission

By clicking ‘Submit and Sign Application’ below, you electronically sign this application and agree that your electronic signature has the same legal effect as your handwritten signature. For a joint application, each applicant certifies, authorizes, and electronically signs this application by agreeing to its submission. You certify 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 us in writing immediately. You also agree to notify us of any change in your name, address, or employment within a reasonable time thereafter. You authorize the Credit Union to obtain credit reports in connection with this request. You understand that it is a federal crime to willfully and deliberately provide incomplete or incorrect information on requests made to federal credit unions or state chartered credit unions insured by the NCUA. You also understand that the Credit Union will rely on the information in the request and your credit report to make its decision.