Purpose:
Amount:
Member Number:
Name:
SSN:
Email:
Complete Address:
How Long:
Rent/Mortgage:
Home Phone/ Work Phone:
Employer Name/ Employment Start Date:
Gross Monthly Salary:
Additional Income/Source*:

*Alimony, child support, or separate maintenance need not be revealed unless
  you want such income considered as a basis for repayment of this obligation.

Comments:

We are not affiliated with SAFE Credit Union in CA.  If you experience any difficulties with this loan application, you may email your response to: lsc@safefed.org.

This credit union is federally insured by the National Credit Union Administration.
2007 SAFE Federal Credit Union
P. O. Box 2008, 160 West Wesmark Blvd., Sumter, SC 29151
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