CONSUMER LOAN APPLICATION

If this is an application for joint credit, Applicant and Co-Applicant each agree and acknowledge the intent to apply for joint credit (sign below)

Joint Credit Application? *

APPLICANT INFORMATION

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Complete only for joint or secured credit, or if you reside in a community property state (AZ, CA, ID, LA, NM, NV, TX, WA, WI)
Application is for (If Co-Applicant is other than spouse, separate application is required) *
Self Employed *
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This Address, you _______ *
 
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Member Signature (Applicant) *
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SPOUSE/CO-APPLICANT INFORMATION

Complete this section if spouse will be contractually liable for the repayment or if applicant is relying on the income of the spouse as community property or on alimony, child support or separate maintenance income for repayment.
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(Alimony, child support or serparate maintenance need not
be revealed unless you want such income considered
as a basis for repayment of this obligation)
 
Member Signature (Co-Applicant) *
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EMPLOYMENT DATA : please attach recent pay stubs. Retirees attach evidence of income (benefits and award letters).

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Present Work Status *
(Alimony, child support or serparate maintenance need not
be revealed unless you want such income considered
as a basis for repayment of this obligation)

ASSETS INFORMATION - AUTO

REAL ESTATE (RESIDENCE)

There are costs associated with the use of a credit card. Information about costs, rates and fees may be found
in the disclosure provided with this application or by calling us toll-free 888-488-9105 or writing us
at Allied Healthcare Federal Credit Union, P.O. Box 93124, Long Beach, CA 90809.

CONSENSUAL SECURITY INTEREST

You grant us security interest in all individual and joint share and/or deposit accounts you have with us now or in the future to secure your credit card account. Shares and deposits in an IRA or any other account that would lose special tax treatment under state or federal law if given as security are not subject to the security interest you have given in your shares and deposits. You may withdraw these other shares unless you are in default. When you are in default, you authorize us to apply the balance in these accounts to any amounts due. For example, if you have unpaid credit card balance, you agree we may use funds in your account(s) to pay any or all of the unpaid balance.

By signing or otherwise authenticating below, you are affirmatively agreeing that you are aware that granting a security interest is a condition for the credit card and you intend to grant a security interest. You acknowledge and agree that your pledge does not apply during any periods when you are a covered borrower under the Military Lending Act. For clarity, you will not be deemed a covered borrower, and your pledge will apply, if (i) you become obligated on a credit transaction or establish an account for credit when you are not a covered borrower; or (ii) you cease to be a covered borrower.
Security Interest Acknowledgement and Agreement (Applicant) *
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Security Interest Acknowledgement and Agreement (Co-Applicant) *
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BY SIGNING BELOW, I/WE CERTIFY THAT THE INFORMATION ON THIS APPLICATION IS ACCURATE, TRUE AND CORRECT. IF THERE ARE IMPORTANT CHANGES IN OUR FINANCIAL CONDITION, I/WE WILL NOTIFY YOU IN WRITING IMMEDIATELY. I/WE UNDERSTAND THAT ANY FALSE STATEMENT FOR THE PURPOSE OF INFLUENCING IN ANY WAY THE ACTION OF ANY FEDERAL CREDIT UNION UPON ANY LOAN APPLICATION IS A VIOLATION OF SECTION 1014, TITLE 18 U.S. CODE. IF APPLICABLE, YOU ARE AUTHORIZED TO MAKE INQUIRIES TO MY/OUR EMPLOYER(S) AS TO MY/OUR SALARY, PAYROLL DEDUCTIONS, ADDRESS OR ANY OTHER PERTINENT INFORMATION AND MAY ALSO REQUEST INFORMATION PERTAINING TO MY PAST, PRESENT OR FUTURE EMPLOYMENT RECORDS. I/WE AGREE TO PAY ALLIED HEALTHCARE FEDERAL CREDIT UNION FOR TRANSACTIONS POSTED TO MY/OUR ACCOUNT IN ACCORDANCE WITH THE LOAN AGREEMENT AND ANY DISCLOSURE STATEMENT, THE TERMS AND CONDITIONS OF WHICH ARE INCORPORATED HEREIN BY THIS REFERENCE. I/WE AGREE THAT ANY RESULTING LOAN SHALL BE INTERPRETED IN ACCORDANCE WITH APPLICABLE FEDERAL LAW AND THE LAWS OF THE STATE OF CALIFORNIA WITHOUT RESORT TO CALIFORNIA’S CONFLICTS OF LAW RULES. I/WE AGREE THAT I/WE ARE RESPONSIBLE FOR THE TRANSACTIONS ON MY/OUR CREDIT ACCOUNT(S) WITH YOU BY ME/US OR BY ANYONE ELSE I/WE AUTHORIZE TO USE THE ACCOUNT EVEN IF THAT PERSON EXCEEDS MY/OUR PERMISSION. THIS INCLUDES, BUT IS NOT LIMITED TO, THE USE OF ANY CHECKS ISSUED TO ME/US AND ANY DUPLICATES AND RENEWALS, AS WELL AS, ANY ADDITIONAL CHECKS ISSUED TO MY/ OUR AUTHORIZED USERS AND ANY DUPLICATES AND RENEWALS THEREON. I/WE AUTHORIZE YOU TO GATHER WHATEVER CREDIT INFORMATION YOU CONSIDER NECESSARY AND APPROPRIATE. I/WE AUTHORIZE YOU TO GIVE INFORMATION CONCERNING YOUR CREDIT EXPERIENCE WITH ME/US TO OTHERS. I/WE WAIVE THE PROVISIONS OF CALIFORNIA VEHICLE CODE 1808.21 (OR ANY OTHER STATE) AND AUTHORIZE THE CALIFORNIA DEPARTMENT OF MOTOR VEHICLES (OR ANY OTHER STATE) TO FURNISH MY/OUR RESIDENCE ADDRESS TO YOU. I/WE UNDERSTAND THAT YOU WILL RETAIN THIS APPLICATION WHETHER OR NOT CREDIT IS APPROVED.

I/WE AGREE THAT AN ELECTRONIC SIGNATURE WITH ONLINE SUBMISSION, PHOTOCOPY OR FACSIMILE OF THIS APPLICATION SHALL BE AS BINDING AS THE ORIGINAL AND SHALL BE ADMISSIBLE IN LIEU OF THE ORIGINAL IN ANY PROCEEDING IN WHICH IT IS, OR MAY BE, A RELEVANT DOCUMENT.

SPECIAL RULE FOR APPLICANTS UNDER AGE 21: IF YOU ARE (A) LESS THAN 18 YEARS OLD OR (B) YOU ARE LESS THAN 21 YEARS OLD AND DO NOT HAVE THE INDEPENDENT ABILITY TO MAKE THE REQUIRED PAYMENTS ASSUMING A UTILIZATION OF THE FULL CREDIT LIMIT REQUESTED, YOU MUST PROVIDE A CO-APPLICANT WHO HAS THE ABILITY TO REPAY, COMPLETE THE CO-APPLICANT SECTION REGARDING THAT PERSON, AND YOUR CO-APPLICANT MUST SIGN AND DATE BELOW. IF YOU ARE LESS THAN 21 YEARS OLD AND HAVE AN INDEPENDENT ABILITY TO REPAY THE FULL CREDIT LIMIT REQUESTED, A CO-APPLICANT IS NOT NECESSARY UNLESS OTHERWISE REQUIRED ACCORDING TO THE RULES ABOVE.
Member Signature (Applicant) *
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Member Signature (Co-Applicant) *
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