Home Equity Application - American 1 Credit Union

DISCLAIMER: I/We hereby certify that all statements made are true and complete, are submitted for the purpose of obtaining credit, and that the credit union may rely on them for such determination. We understand that federal law requires the verification of identification for all new accounts should I not have an existing account. I/We authorize you to obtain such information as you may require concerning the statements made in this application and proper identification, and agree that the application shall remain your property, and you are authorized to answer questions about your credit experience with me/us.

Co-Applicant Information

First Name:

Middle Name (If no middle name please enter None):

Last Name:

Street Address:

Street Address 2:

City:

State:

ZIP:

How long have you lived at this address?

Primary Phone Number:

Social Security Number:

Birth Date:

/ /

E-Mail Address:

Co-Applicant Color Copy of Photo ID Front:

Co-Applicant Color Copy of Photo ID Back:

AGREEMENT

State:

I accept:

I accept the terms of the disclaimer above and submit my application.