North Wilts Credit Union Loan Application Loan Request Encashment

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North Wilts Credit Union Loan Application Date of Application Loan Number Personal Details Are You an Officer/Volunteer/Employee of the Credit Union Yes______ No______ First Name ________________Title________ Member Number ____________________ Surname ___________________________ Number of Dependant Children ______________ Address ___________________________ Date of Birth _______/______/____________ __________________________ National Insurance Number____________________ Post Code _________________________ Telephone Number __________________________ Housing Details (please tick as appropriate) Home Owner____ Tenant____ Living With Parents____ Other(please state)__________________________ How Long At Present Address___________________ Employment (please tick as appropriate) Unemployed___ Retired___ Self Employed___ Employed___ Time With Employer___________ Employer’s Name & Address ________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ Loan Request Some Loans may require further information and an interview may be arranged. Are you a first time borrower? YES/NO Purpose of loan __________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ Present Share Balance £________________ Existing Loan Balance £________________ New Loan Request £________________ New Loan Total £________________ I would like to pay £________________ (TOTAL) Every WEEK/FORTNIGHT/MONTH £___________into my shares £___________ loan repayment Please make the Cheque payable to ______________________________________________ Encashment Letter Required Important Information YES / NO Interest is charged at 1% per month(12.68%APR) on the reducing balance of loans up to £2000. For members who consistently repay loans to schedule, then loans may be granted above the £2000 and interest is reduced to 0.75% on these loans. If a member defaults on repayments the credit committee may revert the interest back to the Standard 1% rate. The borrower is responsible for the full amount of the loan and any part of the loan outstanding at any time, until the full amount is paid. They should ask for a copy of this loan application form and keep it in a safe place. They should check that the form is filled in correctly, particularly that the repayments are correct. If you wish to cancel the loan application or reduce the amount please let the credit union know. Always keep to the repayment terms of this form. If repayments are missed, more interest will result in larger repayments. If you are having difficulties keeping up repayments, please contact the Credit Union immediately. You have the right to seek independent legal advice regarding this agreement. Registered Office: CAB, 21 High Street, Calne, Wilts SN11 0BS Authorized and regulated by the Financial Service Authority. FSN 213668 FINANCAL STATEMENT Income (weekly/ monthly) Wages/Salary Wages/Salary (Spouse) Tax Credits Pension Child Benefit Other Benefit (name) £ P Expenditure (weekly/monthly) Mortgage/Rent Council Tax Water Rates Gas & Electric Insurances T. V. Licence,Rental,Sky,Cable Etc. Maintenance & Court Fines Telephone/Mobile Housekeeping Clothes/ Shoes Work/ School costs Leisure/Hobbies Hire Purchase Agreements Bank Loans/Catalogues Loan repayments to Family/Friends Other (Name) Other (Name) £ P Other Income (name) Total Total I confirm that the information given above is true and complete. I confirm that all my existing debts have been declared on this form. I authorize any enquiries you may deem necessary in conjunction with this application. Signature ___________________________________________ Date______________________________ Official Use Comments by Collection Point Officer. Has passbook been inspected YES/ NO Are the figures given on loan form accurate YES / NO On what date was interest last added(if applicable) to the passbook __________________________ On what date was dividend last added to the passbook_____________________________________ Any other comments YES / NO Encashment Letter Requested YES / NO Registered Office: CAB, 21 High Street, Calne, Wilts SN11 0BS Authorized and regulated by the Financial Service Authority. FSN 213668

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