1900 S. Jones Blvd., Las Vegas, NV 89146
Tel (702) 871-4746, Fax (702) 871-5041
www.pluscu.org

Loan Application

All applications are reviewed daily during regular business hours.

* = Required Field

Are you currently a Member? Yes  No
Desired Loan Type*
Desired Loan Amount*
What Payment Protection Coverage do you want? II
           
Single Credit Life   Single Credit Disability   Joint Credit Life   None
  II Statement of Intent: The credit union will disclose the cost of this voluntary insurance to you.  A separate
insurance election which discloses the terms and conditions must be signed for coverage to become effective.
Application Type Individual     Joint (Spousal)     Joint (Non-Spousal)
Additional Notes

Primary Applicant Information
Name Information
   
Title First Name* Middle Initial Last Name* Suffix

SSN #*

  

Date of Birth*

    
Address & Contact Information
   
Address*
 
City*
State* Zip*
 
Months at Current Address*
Own / Rent Current Address*
Home Phone*
Cell Phone
Work Phone* XTN
  
Email*
 
Confirm Email*
 
   
Previous Address
Months at Previous Address
Own / Rent Previous Address
 
Note: If you have lived at your current address for less than 2 years, please fill in previous address information.
   
ID Information
  First ID
  
Type*
Description
Number*
Issue Date*
Expiration Date*
  Second ID
  
Type
Description
Number
Issue Date
Expiration Date

Employment & Income Information
  
Employment Status*



Employer's Name*  
Employer's Address*  
Occupation*
Income* /
Time in Field*

 Years

 Months
Hours Worked / Week*
Time at Current Job*
   
Prev Employer's Name
Prev Employer's Address
 
Prev Occupation
Prev Income /
Prev Time in Field

 Years

 Months
 
Additional Income 1 Description   Monthly Income
Additional Income 2 Description   Monthly Income
Additional Income 3 Description   Monthly Income
 
Monthly Childcare / Support Payment  
  
Note: 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.

References
 
 

First Reference
 

Name*
Address*
Phone Number*
Relationship*
 

Second Reference
 

Name*
Address*
Phone Number*
Relationship*
 


I have read and accept the following:
  Terms and Conditions
  VISA Disclosure

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