JOINT BORROWER APPLICATION AND CONSENT FORM

JOINT BORROWER APPLICATION AND CONSENT FORM - FOR EXISTING PENFED MEMBERS
JOINT BORROWER: You are being asked to provide the following information to be considered as a joint borrower on a PenFed credit application
submitted by the below-referenced primary borrower. The creditor can collect this debt from you without first trying to collect from the borrower, and can
use the same collection methods against you as can be used against the borrower, such as suing you, garnishing your wages, etc. If this debt is ever in default,
that fact may become part of your credit record.
Application No.:
Primary Borrower’s Name:
Loan Product Applied for:
Loan Amount:
JOINT BORROWER APPLICATION INFORMATION
Full Legal Name:
Date of Birth:
Social Security Number or Member Number:
Day Phone:
Relationship to Applicant:
Evening/Cell Phone:
Street Address:
City:
State:
Years There:
Zip:
Email Address:
Number of Dependents:
INCOME AND EXPENSES
Employment Status:
Self-employed?
Employer Name:
Yes
No
Position Title:
Length of Employment:
Years
Months
Employer Street Address:
City:
State:
Gross Monthly Income: $
Monthly Housing Cost: $
Other Monthly Income: $
Other Income Source*:
Zip:
Mortgage
Rent
*Alimony, child support or separation maintenance income need not be revealed if you do not wish to have it considered as a basis for repaying this
obligation.
BY SIGNING BELOW I EXPRESS MY INTENTION TO APPLY FOR JOINT CREDIT.
CREDIT TERMS AND CONDITIONS
I certify all statements are true and complete and are submitted for the purpose of obtaining credit from you. Further, I certify I am the person stated above
who is submitting this application. I acknowledge that Section 1014 of Title 18 of the U.S. Code makes it a federal crime for anyone to make false statements
or reports, or willfully overvalue property or securities for the purpose of inducing or influencing the action of a federal credit union on an application for
a loan, extension or renewal of the same, or for the acceptance, release, or substitution of collateral. I expressly authorize any person, partnership, credit
reporting agency, association, firm, corporation, or personnel office or officer, upon request, to furnish you a credit report or other information concerning
me relevant to the review and evaluation of this application or any subsequent re-evaluation thereof whether it be this application or the resulting loan.
I AUTHORIZE A SECURITY INTEREST IN MY PENFED SHARE ACCOUNT AND ANY OTHER PENFED ACCOUNTS I MAY HAVE (EXCLUDING MY IRA ACCOUNTS)
UP TO THE AMOUNT OF MY OUTSTANDING DEBT TO PROTECT PENFED IF I DEFAULT ON ANY CREDIT EXTENDED OR CASH ADVANCED UNDER THIS/THESE
ACCOUNT/S.
Signature:
Date:
Form 4 (02/16) © Pentagon Federal Credit Union, 2016