Credit Union Atlantic

* = REQUIRED FIELDS

Loan Information

Application Type: Energy Efficient Financing         
 
Requested Amount
 
Home Type:
Electrically heated
 
Non-electrically heated (oil, wood, etc.)
 
Interest Term:
 
Amortization:
maximum amortization is 10 years, with a maximum interest term of five years
 


Personal Information

Last Name *
First Name *
Middle Name
Birth date *
SIN
Address - Street *
City *
Province *
Postal Code *
How long at this address (yrs)*
Previous Address (if at current address less than 2 yrs)
Primary Phone # *
Secondary Phone #
Email Address *
Preferred Method of Contact (i.e. email, telephone, work, home, cell)
Are you a CUA Member? Yes No
CUA Shares $
Marital Status: *
Single Married Common Law Separated/Divorced

Co-Applicant Personal Information

Last Name
First Name
Middle Name
Birth date
SIN
Same Address as Buyer? Yes No
Address - Street
City
Province
Postal Code
How long at this address (yrs)
Previous Address (if at current address less than 2 yrs)
Marital Status:
Single Married Common Law Separated/Divorced

Buyer Employment & Income

Employment Status*
Employment Type (please complete if above answer is Other-Undergraduate(University) or Other-Graduate(Masters/PHD)
Occupation / Position *
Employer *
Employer Phone* ext
Employers Complete Physical Address Including postal code *
How long have you been working there? (yrs)*
Gross Income (Monthly)*
Additional Income (Monthly)
Identify Source for Additional Income
    If Other please Specify
Previous employer (if less than 2 years in current position)
How long were you there for? (yrs)
Occupation / Position

Co-Applicant Employment & Income

Employment Status
Employment Type (please complete if above answer is Other-Undergraduate(University) or Other-Graduate(Masters/PHD)
Occupation / Position
Employer
Employer Phone ext
Employers Complete Physical Address Including postal code
How long have you been working there? (yrs)
Gross Income (Monthly)
Previous employer (if less than 2 years in current position)
How long were you there for? (yrs)
Occupation / Position

Buyer Financial Information

Do You Have a Mortgage?* Yes  No
Monthly Mortgage Payment*
 Include the total amount including principal, interest and property tax payments.
Estimated Mortgage Balance
Estimated Property Value
Monthly Support Payments?* Yes  No If yes, indicate your total monthly support payment

Pre-Authorized Payment Information

Financial Institution
Branch Address
Bank ID (3 Digits)
Transit Number (5 Digits)
Account Number




Additional Information

  BuyerCo-Buyer
Have you ever been?Bankrupt *Yes NoYes No
  Date:Date:
 Orderly Payment of Debts *Yes NoYes No
Will this loan be used by or on behalf of a third party?*No Yes
 If "Yes", please complete and attach a Third Party Determination form.
Are you now (or do you anticipate being) involved in litigation? *Yes NoYes No
 
Please indicate which CUA branch location you would prefer * Branch 



Additional Documentation

Please email any documentation required. Email Documents



If I/we choose to provide the Credit Union with my/our Social Insurance Number(s), I/we authorize the Credit Union to use it for verifying and reporting credit information to credit bureaus and credit reporting agencies. I/We understand that I/we may refuse to consent to its use or disclosure for these purposes. This consent and authorization is provided on the condition that the Credit Union is in compliance with any applicable legislation, including the Personal Information Protection and Electronic Documents Act (Canada). I/We understand that I/we may obtain more information regarding the Credit Union's commitment to protecting my/our privacy including my/our right to limit or withdraw my/our consent and authorization respecting my/our Personal Information by reviewing the Credit Union's Privacy Code, which will be provided to me/us at my/our request. I/We hereby certify that all statements made in this credit application are true and complete and submitted for the purpose of obtaining credit.