Apply for a Loan

Please provide all the requested information. When you have completed the form, press the Submit button to send your application. If necessary, we will contact you for additional information.

Loan Information

How Many?
Will there be a co-applicant on this application?
$
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.
Do you want your loan protected for you and your family if you become disabled (Credit Disability)?
 
Do you want your loan protected for you and your family in the event of your death (Credit Life)?
 
Do you want your auto loan protected by Guaranteed Asset Protection insurance (GAP)?
 
Primary Applicant

(mm/dd/yyyy)
 
 
(-
(-
(-

 
Home Address
Type of Residence
$
Time at Current Residence
Present Employer
(-
Employment Status
(mm/dd/yyyy)
 
$
 
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.
Co-Applicant

(mm/dd/yyyy)
 
 
(-
(-
(-

 
Home Address
Type of Residence
$
Time at Current Residence
Present Employer
(-
Employment Status
(mm/dd/yyyy)
 
$
 
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 1-844-734-2812 or Williamsport at 1-855-735-8331, 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 below, you promise that everything you have stated in this request 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.