School Information (Required)
School Name: | School Type: c 2-Year Month | c Part Time c Sr. c Graduate c Other c 4-Year c Trade School Year |
College Auto Loan/Credit Card Application
This form serves as a master loan application, covering all loans offered by Provident except real estate. The information you provide on this application will be kept permanently on file. We may ask for a copy of your most recent pay stub or income verification. When you want to borrow again, just call us with your updated information.
Co-Applicant/Joint Borrower (if applying for joint credit)
Last Name Social Security Number Birth Date Address First Name Driver’s License/I.D. Number Mother’s Maiden Name How Long (yrs/mos) M.I. State
Graduation Date:
Student Status: c Full Time Class: c Fr. c So. c Jr.
Type of Credit Requested
c College Auto Loan Amount Requested: $
College Checking Application
Member Number (new member—leave blank) Name Joint Owner Name Joint Owner Social Security Number Home Phone Number Driver’s License/I.D. Number Joint Owner Driver’s License Number Joint Owner Birth Date
Term (Years):
($15,000 maximum) (Up to 5 years)
City/State/Zip Previous Address (if at current address for less than 2 years) Previous City/State/Zip Work Phone (Include Area Code) Employer Home Phone (Include Area Code) Job Title Department How Long (yrs/mos)
I would like to make my College Auto Loan payments through: c Automatic transfer from my Provident account:
(Without automatic transfer, interest rate is 2% higher)
c Checking
c Savings
c Standard monthly billing or coupons
Name of Beneficiary (if no joint owner or upon death of both owners)
c College Visa Card
Employer Address City/State/Zip Gross Annual Income Date of Hire
Check Options
In addition to my name and address (as it is on file at Provident), I would like my checks to be printed with the following options: c Phone Number c Joint Owner Name c Do not want Checks
Applicant
Member Number: Marital Status: c Married Number of Dependents: c Unmarried c Separated
Previous Employer (if current is < 2 yrs)
Previous Work Phone (Include Area Code)
Overdraft Protection
Overdraft protection is automatic in the order listed below if applicable. Indicate below if you want a different order, or if you do not want overdraft protection: c Do not want overdraft protection Provident College Visa Savings Joint Owner Initial* Joint Owner Initial*
Insurance Services
Last Name Social Security Number Birth Date Address City/State/Zip Previous Address (if at current address for less than 2 years) Previous City/State/Zip Work Phone (Include Area Code) Employer Employer Address City/State/Zip Gross Annual Income Previous Employer (if current is < 2 yrs) Other Income Date of Hire Previous Work Phone (Include Area Code) Source Home Phone (Include Area Code) Job Title Department How Long (yrs/mos) First Name Driver’s License/I.D. Number Mother’s Maiden Name How Long (yrs/mos) M.I. State
Provident Plus Insurance Agency, our subsidiary, can help you with insurance for your auto, home, and personal property. For a free quote or more information, call (800) 310-0395 or visit us online at providentcu.org/insure. If you already have a policy, a representative will provide you with a free quote approximately 30 days before your current policy expires. Initial and write the expiry date to receive a quote on the following policies: Auto Initial: Expires: Home Renter’s Initial: Initial: Expires: Expires:
Money Market c Savings Joint Owner Initial* c Checking VIP Line of Credit Joint Owner Initial*
* Joint owner approval is required for overdraft protection if the joint owner on your checking account is different from the joint owners on the accounts from which your overdraft funds are drawn.
Free Visa Check Card
You and your joint owner (if applicable) will be issued and mailed a Visa® Check Card. c Do not want a Visa® Check Card
Initial Deposit
Please enclose your initial checking deposit of $25 or more to open your account. Make check payable to Provident Credit Union.
Protection is voluntary on all plans. Insurance products are not products of Provident Credit Union and are not protected by the NCUA. They are not an obligation of or guaranteed by Provident Credit Union and may be subject to risk. Any insurance required as a condition of an extension of credit by Provident Credit Union need not be purchased from the Credit Union and may be purchased from an agent or an insurance company of the member’s choice. Provident Services Corporation, a wholly owned subsidiary of Provident Credit Union, does business as Provident Plus Insurance Agency. Business conducted with Provident Plus Insurance Agency is separate and distinct from any business conducted with Provident Credit Union.
Signatures
Faxed documents/signatures are considered as legally binding as original documents/signatures and shall be sufficient unless originals are required by a third party. By signing below, I/we acknowledge receipt of Provident’s Master Disclosure, Fee Schedule, and Privacy Notice or acknowledge copies will be mailed to me/us and agree to their terms and conditions. This authorizes Provident to do an independent credit review, including the verification of my employment history, and obtaining credit reports now and in the future. Provident will also review all signers through ChexSystems. Provident has the right to furnish other credit reporting services with information about my credit.
Signatures
Everything I have stated in this application is true and complete. I understand that it is a crime to furnish inaccurate information in a credit application. This authorizes Provident to do an independent credit review, including the verification of my employment history, and to obtain credit reports now and in the future. Provident has the right to furnish other credit reporting sources with information about my credit.
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.
X X
Primary Member Signature
Date
c Rent
c Own
c Live with Parents
X X
Primary Member Signature
Date
Rent/Mortgage Payment:
Date
Joint Owner Signature
Date
Joint Owner Signature
Once you’ve completed, printed, and signed this application, return it to Provident: • bring to a Provident Community Branch, • or fax to (650) 595-2409* • or mail to: Provident Credit Union Attn: Marketing 303 Twin Dolphin Drive Redwood Shores, CA 94065-1409 Remember to include the following: • Check made payable to Provident Credit Union • Copy of Driver’s License or State I.D. for each signer** • Proof of Enrollment in a 2- or 4-year college, university, or trade school Membership is required: • See the “Join” section of providentcu.org for details on joining Provident.
* You can fax your application if funding your account via a Transfer of Funds Request or Direct Deposit/Payroll Deduction. Faxed documents/signatures are considered as legally binding as an original document/signature and shall be sufficient unless originals arerequired by a third party. ** Pursuant to the USA Patriot Act (Uniting and Strengthening America by Providing Appropriate Tools Required to Intercept and Obstruct Terrorism), federal law requires all financial institutions to obtain, verify, and record information that identifies each person who opens an account.