Cheshire Councils Employees Credit Union Member No Car Loan Application Loan No To support your application you will need to supply certain documents as evidence. Please see the notes as you complete the form. Failure to supply requested documents will delay your application. Name Mr/Mrs/Ms/Miss/Dr/Other: Home address: Postcode: Tel No: Date of Birth: How long have you lived at this address, if less than 3 years please give previous address(s) Email: home/work Mobile/daytime Tel no: Are you employed (Please provide copy of contract)? Full time / Part time / permanent/ temporary contract Start date of employment Occupation Your Income and expenditure, please supply your 3 most recent bank statements and payslips, proof of benefit(s), pension, tax credits. Copies of documents are acceptable. We cannot return originals by post. £ per £ per £ per £ per Income Expenditure week month week month Net pay after Rent/mortgage deductions Child Benefit Council Tax Insurance, inc home, car, dental, pet, State Pension health Job Seekers Car expenses inc petrol, road tax, Allowance mot, servicing. Income support Food, inc eating out Incapacity Benefit Gas, Electric, Water Disabled Living Telephone inc mobile and broadband Allowance Child Tax Credit Savings inc pension fund TV license, Sky Working tax Credit Other(please Leisure, inc days out, holidays specify) Cinema etc Nursery/childminder fees Clothing inc school uniforms Other Cheshire Councils Employees Credit Union is branch of Cheshire Neighbours Credit Union Ltd and is authorised and regulated by the FSA Registered No 215692 Version 1. Total Income £ £ Total Expenditure £ £ Your Debts, do not include any existing credit union loans. Payment £ per Type of Debt Name of Creditor Original Amount Current Balance week/month Credit Card Store Card Car Loan HP/Catalogues Other (Please Specify) Total £ £ £ Do you have any County Court Judgements, default notices or charging orders against you? YES/NO Are you an un-discharged bankrupt or subject to an Independent Voluntary Arrangement? YES/NO If you have answered yes to either of the above questions please provide details on a separate sheet. Failure to disclose may result in your application being refused. A condition of this loan is that we require proof of purchase of a vehicle within 8 weeks of the loan being issued. If proof is not provided, the loan will be viewed as fraudulent and will revert to Credit Union standard rate of interest and may also be recalled. How much do you want to borrow? £ over what period (months) I have given due consideration to all other financial commitments and feel confident that I shall be able to make repayments in accordance with Credit Union rules. To the best of my knowledge and belief I am in good health and that I will inform the credit union immediately of any changes in my circumstances that my affect my loan. I understand that all loans are subject to approval and availability of funds. To the best of my knowledge and belief, the information I have given is accurate and full and that the credit union may take appropriate action if I am found to have deliberately provided false or misleading information. Applicants signature Date Payment will be made by direct transfer to your bank or Building Society account, please complete the account details below. Name and address of your Bank or Building Society Name(s) of account holder (If different from above provide full name and address): Sort Code Account OR as a CHEQUE payable to (Cheque will be posted to your home address) Return completed application and documents to a member of staff or post to Cheshire Councils Employees Credit Union is branch of Cheshire Neighbours Credit Union Ltd and is authorised and regulated by the FSA Registered No 215692 Version 1. Cheshire Councils Employees Credit Union, Room 132, The Forum, Chester, CH1 2SH. Tel 01244 973752 Email us at email@example.com In accordance with the principles of Data Protection Act 1998, we will use your personal details for the purposes of managing your accounts with the credit union. Your personal details will be treated confidentially and will only be shared with other agencies for the purposes of credit referencing and debt recovery and by signing this application you provide your consent. Cheshire Councils Employees Credit Union is branch of Cheshire Neighbours Credit Union Ltd and is authorised and regulated by the FSA Registered No 215692 Version 1.