LOAN APPLICATION FORM
In order to enable our Loan Officers to deal promptly with your application please answer all questions in full. Write N/A where
questions are not applicable to you. Members who have not reached the age of 18 years are required to have their loan co-signed by
their Parent/Guardian. Our staff will gladly provide you with assistance if required. (Use BLOCK CAPITALS please)
1. Personal Information
Name: ___________________________________________ Account Number: ___________ Date of Birth: _____ /_____ /_____
Address: ____________________________________________________________ _________________________________________
Contact Number:_______________________________ PPS number: _______________________________________________
Marital Status: Married Single Separated Co-Habiting Widowed Other_________________
No. of dependants (incl. children) ___________ Maiden Name: _____________ Email Address:________________________________
Nationality: Irish Other EU Non EU (specify)_________________ Visa Type & Expiry Date: ____________ ___ /___ /___
Member of another Credit Union (please circle) YES / NO IF YES—Name of Credit Union
2. Loan Details
I/We hereby apply for a loan of for the Purpose of
With repayments of to be paid: Weekly Fortnightly Monthly / Term: paid back within yrs
Do you wish to top-up your existing loan? Yes No
Current Loan Balance: €_________________ I / We wish to Pledge €____________ of my/our shares against this loan.
€
€
3a. Applicant’s Employment Details
Permanent Temporary Retired Not Employed Part-time Part- time hours worked per week
Self –Employed Student Homemaker Date Employment Commenced: _____ /_______ /_____
Name & Address of Employer Position:
Salary (take home pay) Weekly Fortnightly Monthly Annually
Other Income: Social Welfare Child Allowance Maintenance
FIS Pension Rental Income Other (please specify)
€
4. Housing Details
Type of Accommodation: Owner Tenant Family Home Other______________ No. of years at this address
Previous Address (if less than 3 years at present address)
Why did you consider Link Credit Union for your loan:
Promo Flyer Social Media Word of Mouth Ad in Office Radio Other:
€ € €
€ € €
3b. Declaration of other Financial Commitments List all debtors, loans and Expenditure: Rent, Mortgage, Personal Loans, Car Loans, Hire Purchase, Finance, Credit Cards, Guaranteed loans Wkly F/ntly Mthly
If any of the following arrangements apply to your mortgage repayments: (PLEASE CIRCLE) interest only / arrears capitalised / reduced repayments / or in any forbearance - please provide a copy of the agreement.
Name of Creditor Original Debt Current Balance Repayments Joint Names Y/N
Rent/Mortgage € € €
Car Finance € € €
Other Loan € € €
Credit Card € € €
Overdraft €
Name of Creditor Original Debt Current Balance Repayments Joint Names Y/N
Rent/Mortgage € € €
Car Finance € € €
Other Loan € € €
Credit Card € € €
Overdraft €
6. Consent to Use and Disclosure / Data Protection Acts, 1988 & 2003 | ICB Consent | CCR
I understand that under the Data Protection Acts, 1988 & 2003 (“the “DPA”), my consent may be required for the Credit Union to process personal data which it may
have in its possession concerning me (including disclosure to third parties). I note that this personal data may include sensitive personal data, such as data about
my health, within the meaning of the DPA, the processing of which requires my explicit consent. I also understand that under Section 71 of the Credit Union Act,
1997, the Credit Union, subject to exceptions listed in the Section, shall not disclose or permit to be disclosed, without my consent, any information that concerns an
account or transaction of mine with the Credit Union. For the purpose of assessing any applications (including loan applications) which I may make to you and
generally for administering and monitoring any accounts I have with the Credit Union, including any loan accounts I have from time to time with you. I consent:
1. (i) to you seeking information concerning applications for loans and my credit history from the date of my original consent from any credit union and from any credit reference bureau or agency and for that purpose you may disclose any relevant information in any loan application which I may make to you or which you
may have concerning me to any such credit union or any such credit reference bureau or agency;
(ii) to any Credit Union or any credit reference bureau or agency disclosing information to you concerning applications for loans and my credit history from the date
of my original consent with any such Credit Union or otherwise;
(iii) to the processing of any information relating to me, either contained in this form or application, for the purpose of assessing applications and administering any
accounts I maintain with the Credit Union.
(iv) to authorise Link Credit Union Ltd. to process and retain data provided by me/us in respect of this application, to seek and provide credit references (searches), to record details of any transaction which may result from this application with the Irish Credit Bureau (ICB) and ICB to record, retain and disclose to its members details of such searches for a period of one year. I/We acknowledge that Link Credit Union Ltd. and/or ICB are permitted to disclose any material misstatement of fact in the application for financial accommodation to its members and relevant bodies. I/We consent to any such application being processed, recorded and
retained by ICB.
Notice: Under the Credit Reporting Act 2013 lenders are required to provide personal and credit information for credit applications and
credit agreements of €500 and above to the Central Credit Register. This information will be held on the Central Credit Register
and may be used by other lenders when making decisions on your credit applications and credit agreements.
2. From time to time, Link Credit Union, or third parties used / selected by Link Credit Union, may use your details to inform you of goods and/or services (being offered by Link Credit Union only) which may be of interest to you. The use of your details for marketing purposes will depend on the preferences that you
express below.
I consent to Link Credit Union, informing me of goods or services (being offered by Link Credit Union only) that may be of interest to me. I understand that I will have the option to “Opt-Out” of receiving this correspondence at any stage.
Please TICK your preferred medium for receiving information messages from Link Credit Union Ltd.:
I wish to Opt—in to receiving email contact from Link CU I wish to Opt-in to receiving SMS contact from Link CU
I wish to Opt—out of receiving postal contact from Link CU
Date:
5. Spouse/Partner’s Employment Details — (Spouse/Partner to Complete this section only if you need to include your
their income to support your loan application)
Spouse / Partner’s Name: ____________________________ Maiden Name (if applicable): _______________ DOB: ___ / ____ / ____
Permanent Temporary Retired Not Employed Part-time Part- time hours worked per week
Self –Employed Student Homemaker PPS Number: _______________________________
Name & Address of Employer: _____________________________________ Position: _______________________________
Salary (take home pay) Weekly Fortnightly Monthly Annually
Other Income: Social Welfare Child Allowance Maintenance
FIS Pension Rental Income Other (please specify)
List all debtors, loans and Expenditure: Rent, Mortgage, Personal Loans, Car Loans, Hire Purchase, Finance, Credit Cards, Guaranteed loans Wkly F/ntly Mthly
If any of the following arrangements apply to your mortgage repayments: (PLEASE CIRCLE) interest only / arrears capitalised / reduced repayments / or in any forbearance - please provide a copy of the agreement. Spouse/Partners Declaration: I consent to my Income & Expenditure being considered to support the loan application of my spouse/partner. I consent to Link Credit Union Ltd carrying out a credit check with the Irish Credit Bureau & retaining this information to comply with Data Protection Legislation. I have read & understood the ICB Consent in Section 6 of this form.
Signed: Date:
Name of Creditor Original Debt Current Balance Repayments Joint Names Y/N
Rent/Mortgage € € €
Car Finance € € €
Other Loan € € €
Credit Card € € €
Overdraft €
€
€ € €
€ € € €
FOR OFFICE USE ONLY
LOAN APPLICATION: Witnessed / Received by: Date Received:
Documents: In Order Outstanding:
Loan Application Decision: Approved Refused Deferred to: Initials:
Proposed Guarantor — (Complete this section ONLY if you need to provide a Guarantor to support your loan application)
IF YOU ARE UNSURE OF WHAT DETAILS YOU NEED TO PROVIDE AS GUARANTOR—PLEASE CONTACT OUR OFFICE
Name: _______________________________ Address: ___________________________________________ DOB: ___ / ____ / ____
Contact Number: __________________________ Account Number: _____________ Relationship to Member: __________________
Permanent Temporary Retired Not Employed Part-time Part- time hours worked per week
Self –Employed Student Homemaker PPS Number: ________________________________________
Name & Address of Employer Position:
Salary (take home pay) Weekly Fortnightly Monthly Annually
Other Income: Social Welfare Child Allowance Maintenance
FIS Pension Rental Income Other (please specify)
List all debtors, loans and Expenditure: Rent, Mortgage, Personal Loans, Car Loans, Hire Purchase, Finance, Credit Cards, Guaranteed loans Wkly F/ntly Mthly
I consent to my Income & Expenditure being considered to support the loan application of ______________________________________________.
I consent to Link Credit Union Ltd carrying out a credit check with the Irish Credit Bureau. I have read & understood the ICB Consent in Section 6 of
this form. I understand that up to 25% of my shares will be held as security against this loan and should this loan fall into arrears I understand that
100% of my shares held with Link Credit Union will be frozen until such a time as the loan repayments are up to date. I understand that should this
loan default it is my responsibility to make repayments. I am also aware that this affects my Future loan applications with Link Credit Union.
I understand that these conditions last as long as the guaranteed loan remains outstanding.
Signed: Date:
€
€ € €
€ € €
7. ADDITIONAL INFORMATION PLEASE INCLUDE ANY ADDITIONAL INFORMATION THAT MIGHT ASSIST WITH THE PROCESSING OF THIS LOAN APPLICATION:
______________________________________________________________________________________________________________
______________________________________________________________________________________________________________
______________________________________________________________________________________________________________
______________________________________________________________________________________________________________
______________________________________________________________________________________________________________
______________________________________________________________________________________________________________
Name of Creditor Original Debt Current Balance Repayments Joint Names Y/N
Rent/Mortgage € € €
Car Finance € € €
Other Loan € € €
Credit Card € € €
Overdraft €
8. Member Declarations: (please tick as appropriate)
I/We agree that we will not apply for another Top-Up on this loan for at least another 6 weeks
I/We understand that this loan application and any subsequent loan offer is valid for 90 days from the date of application approval
I/We understand that the repayment associated with this loan application is not protected by Repayment Protection Insurance
I/We confirm that this loan will be used for the purpose stated in Section 2.
I/We are not indebted to any other Credit Union , Bank or Loan Agency either as a borrower or guarantor except as stated, the statements herein are made
for the purpose of obtaining the loan and are true to the best of my/our knowledge and belief.
Yes No Yes No Date Date: Date:
CU NAME: LINK CREDIT UNION (ROI) CONTACT NAME: _______________________
IMPORTANT—PLEASE REMEMBER THAT YOU MUST TELL US EVERYTHING RELEVANT IN ANSWER TO ALL OF THE QUESTIONS ON THE
DECLARATION FORM. IF YOU DO NOT OR IF ANY OF THE ANSWERS TO THESE QUESTIONS ARE NOT TRUE AND COMPLETE, ANY
INSURANCE COVER PROVIDED COULD BE VOIDED. A MATERIAL FACT (RELEVANT INFORMATION) INCLUDES ANYTHING WHICH A
REPUTABLE INSURER WOULD REGARD AS LIKELY TO INFLUENCE THE ASSESSMENT OF AN APPLICATION FOR INSURANCE
The Loan Protection Insurance Policy exists solely between ECCU Assurance and Link Credit Union Ltd.
ECCU Assurance Company Limited, (“ECCU”), will hold your details in accordance with its Data Protection Policy & all applicable data protection laws
and principles. Information you supply will be used for the purposes of administering your credit union’s insurance policy with ECCU. This includes
underwriting, storage and processing by computer and manual record systems, claims handling & fraud prevention. We may also collect sensitive
personal data, e.g. information relating to your physical/mental health, to assess the terms of insurance cover or to administer claims which arise. We
may share the information for these purposes with agents or service providers we have appointed, regulatory organisations, other insurance and
reinsurance companies, those to whom we outsource certain business operations & as required by law. You have a right of access to & a right to
rectify data concerning you under the Data Protection Acts 1988&2003, for which a small fee is chargeable. By providing us with your information &
signing Section A of this form, you consent to all of your information being used, processed, disclosed, transferred & retained by ECCU & Link CU.
SECTION A—MEMBER DECLARATION Part 1—Personal Details
Member’s Name: ______________________________ Account Number: ____________________
Date of Birth: _______/______ /______ Present outstanding Loan Balance: €______________
Additional Loan now Required: €________________ Total balance for cover: €_________________________
Part 2—Which of the following Statements best describes your normal occupation or duties?
WORKING means actively at work and regularly performing all the usual duties of your occupation; or
not actively at work solely because of a temporary minor sickness or injury; or not actively
at work solely because of a maternity leave, parental leave, redundancy, unemployment or
other lack of work, strike or holiday provided that you are at that time physically and/or
mentally able to be active at work & can regularly perform all the usual duties of your occupation.
RETIRED means someone who is retired from paid employment (other than on ill health grounds)
and able to carry out the normal duties of a retired person.
STUDENT means a full time education student, aged 16 years or older actively and regularly
performing all of the usual activities of a student of the same age.
HOMEMAKER means a housewife, househusband or homemaker actively and regularly performing all of
the usual duties of a homemaker.
NONE OF THE ABOVE
Part 3 I confirm I am fit to follow my normal occupation or duties (as indicated in part 2). Yes No
Part 4 Are you receiving an illness or injury related benefit for more than 3 months? Yes No
Member’s Signature: _________________________________________ Date Signed: _____________________________
SECTION B—SPECIALIST DECLARATION
Have you been referred to or seen by a specialist or consultant at a hospital or clinic in the last 12 months with the
exception of routine antenatal check-up’s or routine orthopaedic treatments
(except back conditions)? Yes No
Member’s Signature: _________________________________________ Date Signed:
If you have had previous* loans with Link CU & your total
loan balance will be under €5000 -
We will need:
2 recent Payslips / Social Welfare Receipts / Pension Receipts
Photo ID
Proof of Address—dated within the last 3 months
If this is your 1st Loan with Link CU and / or your total loan
balance will be over €5000 -
We will need:
2 recent Payslips / Social Welfare Receipts / Pension Receipts
3 recent months personal Bank Statements
Photo ID
Proof of Address—dated within the last 3 month’s
If your Partner / Guarantor’s income is being used, all of the
above details are required for them also. Please ensure Section
5 on loan application is completed for Partner.
If you are self employed we will need a copy of your audited
accounts / copy of unaudited accounts accompanied with a Tax
Clearance Certificate.
Page 4 (ECCU Loan Protection Insurance Declarations is
completed
Checklist
Checklist
If you cannot provide payslips, we require a letter from your employer stating:
How long you have worked for the company, Net take home pay and employment status (i.e. full time, part time).
This letter must be on either: company letter-headed paper or stamped by the company. It must also contain your
employers contact number. Your employer is required by law to provide you with a payslip upon your request.
Applying for a loan with Link Credit Union Ltd.
*Terms & Conditions Apply
Why do we need this information?
At Link Credit Union Ltd. our main priority is providing prudent
lending services to our members.
Photo ID — To prove it’s you
Proof of Address — To prove that you are residing at this address.
Purpose of Loan — To record that you are applying for a loan for a
productive purpose.
Proof of Income — To prove that you have the means to repay the
loan
Bank Statements — To confirm that you have the capacity to
meet loan repayments.
Partner / Guarantors Income — Proof of your Partner /Guarantors
income must be produced if you need to include their income
details to support your loan application.
ECCU Loan Protection Insurance Declarations —To ensure that
your Loan Balance is fully covered by our free Loan Protection
To act in your interests and under the E.U. Consumer Credit Directive, we are obliged to ensure
we know our members and access our members credit worthiness by checking your credit
history with the Irish Credit Bureau when assessing loan applications.
www.linkcu.ie | 042-9675000 | [email protected]
Link Credit Union Ltd. is regulated by the Central Bank of Ireland.