Loan Application Form – Dundalk Credit Union

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Rating
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Status
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Topic
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fortnightly repayment
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weekly repayment
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Contact Details
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Name*
First Last
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Email*

Please enter your personal email address.
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Phone*
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Consent*
- I agree to the terms and conditions for access to and use of the Credit Union website and web forms.
Personal Details
Please fill in your Date of Birth*

Day
Month
Year
Do you know your membership number?
- Yes
- No
Please enter your membership number:
Marital Status
What is your PPS number?*

Please enter your home address*
Address Line 1 Address Line 2 Town County Country
Living Situation*
- Home Owner
- Tenant
- Living with Parents
Number of Residents Living At This Address*
Years living at this address*
If resident for less than 3 years please supply previous address
Previous Address
Address Line 1 Address Line 2 Town County Country

Your Employment Details
Employment Status
Are you a public sector employee?
- Yes
- No
Employment Type
Employer Name*
Employer Address*
Address Line 1 Address Line 2 Town County Country
Time in current Employment (in years)*

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Application Details
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Loan Application Amount*
Loan Purpose
Other loan purpose
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Term of Loan (in years)*
Repayment Frequency
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Monthly Repayment
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fortnightly repayment
weekly repayment
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Repayment Amount
Repayment Method
Loan Funds Payout Method

Your Income
Monthly Take Home Pay*
After Tax & Deductions
Are you in receipt of social welfare payments?*
- Yes
- No
What is the total monthly amount of social welfare payments you receive?*
E.g. Child Benefit, Job Seeker's Allowance, Family Income Supplement etc.
Are you in receipt of rental income?
- Yes
- No
Monthly Rental Income
If Applicable
Do you have other monthly income?
- Yes
- No
Other Monthly Income
After Tax & Deductions

Your Outgoings
Type of Monthly Outgoing
Amount
Do you have an additional monthly outgoing?
- Yes
- No
Type of Monthly Outgoing
Amount
Do you have a further monthly outgoing?
- Yes
- No
Type of Monthly Outgoing
Amount
Do you have a further monthly outgoing?
- Yes
- No
Type of Monthly Outgoing
Amount
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Total Monthly Outgoings
Please consider any Mortgages, Loans, Credit Cards, Overdrafts etc.

Declarations and Consents - please read carefully before submitting
Below, the terms ‘we’ or ‘us’ refer to the Credit Union.
Below is important information relating to your application. Please do not submit an application before reading all the information carefully.
*
- l hereby apply to the Credit Union for a Personal Loan subject to the Loan Terms and Conditions of the Credit Union. By ticking the box I confirm that I have read and understood the terms and Conditions.
Are you aware of any known future changes to your circumstances which may affect your ability to repay the proposed loan?
- Yes
- No
Please provide details:
Are you an employee, director or volunteer of the Credit Union?
- Yes
- No
Please provide details:
Are you connected to or related to an employee or director of the Credit Union or connected to a business where an employee or director of the Credit Union is a significant shareholder?
- Yes
- No
Please provide details:
Have you or are you, or any business associated with you; ever been declared bankrupt or insolvent, obtained a Debt Relief Notice, renegotiated your arrangements with creditors or faced court proceedings for debts in Ireland or any other jurisdiction?
- Yes
- No
Please provide details:

Authorisation and Application
Warning: If you do not meet the repayments on your credit agreement, your account will go into arrears. This may affect your credit rating, which may limit your ability to access credit in the future.
I confirm, acknowledge and agree;
- That this Application Web Form together with figures quoted in repayment calculators may not be construed as an offer of credit by or on behalf of the Credit Union.
- That all statements, information and details given in this application and any documentation provided in support of it are true, accurate and complete and I understand they are subject to verification by the Credit Union.
- That the Credit Union may contact my employer to verify my employment details and/or salary information for the purposes of underwriting this application.
- That loan approval is subject to the Credit Union’s credit approval process and lending criteria and that the Credit Union reserves the right to restrict, amend, reduce or withdraw any loan offer made.
- That the loan will be subject to the rates and interest of the Credit Union and I will pay all fees and charges in connection with the loan as set out in the Credit Agreement that will issue to me on the approval of my application.
- That the Credit Union may obtain Repayment Protection Insurance in relation to this credit facility and that availability of such insurance will be subject to a Declaration of Health within the Credit Agreement.
- That loan approval may be subject to conditions as specified in the Credit Agreement. This may include that my shares may be held as security against the loan.
- That upon execution of the Credit Agreement by the Credit Union and I, we will both be bound by that Credit Agreement.
- Pre Existing Condition Limitation – If I have, during the last 6 months, received medical treatment, advice or consultation for an illness, it may affect the insurance benefits payable under the terms of the Credit Union’s Loan Protection Insurance policy. In a case of death within 6 months of the date of this loan due to a pre-existing medical condition, your loan may not be covered by the Credit Union’s policy, in which case your savings, plus any insurance benefit due on these savings, may then be used as security against the value of your outstanding loan.
Consent for Authorisation and Application*
- By ticking the box I confirm and acknowledge the above

Data Processing
*
- By ticking the box I consent to the Processing of my data, which may include sensitive data, for the purposes of reviewing this application in accordance with the Privacy Notice
Credit Checks
STATUTORY NOTICE – Central Credit Register (CCR):

Under the Credit Reporting Act 2013 lenders are required to provide personal 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.

The Central Credit Register is owned and operated by the Central Bank of Ireland. For more information please see: www.centralcreditregister.ie
It is a necessary condition of a credit application that satisfactory credit checks and assessments be conducted by the Credit Union. These will include checks with the Central Credit Register and/or the Irish Credit Bureau DAC or other credit reference agencies.*
- By ticking the box I authorise the Credit Union to conduct additional credit verifications and assessments as necessary for the purposes of considering my application in accordance with the Credit Checks Notice

Receive Certain Notices Electronically
From time to time the credit union would like to send Notices to you electronically including notice of annual general meetings, special general meetings and our annual report. This will allow us to reduce costs and be more environmentally friendly. Please be aware it is a regulatory requirement that Notices may only be sent electronically to personal email addresses and may not be sent to addresses associated with your work or employment.
- By ticking the box I consent to receiving certain Notices electronically
Marketing Consent
From time to time, the Credit Union may wish to inform you of goods, services, products, competitions, promotional offers and Credit Union news which may be of interest to you. The use of your details for these purposes will depend on the preferences that you express below. You can update your preferences at any time by contacting us by letter or phone. Please note, the Credit Union may still contact you where there is a legal or legitimate interest basis for that contact.
Yes, I would like to be contacted by:
- Email
- Text Message
- Post
- Phone
You can select more than one option
- No, I do not want to be contacted:
You can contact the Credit Union in the future if you change your mind and no longer wish to receive marketing communications. You can contact the Credit Union by; You can contact the Credit Union by;

Phone
(042) 93 35489

Website

www.dundalkcu.ie

In branch

Market Street,
Dundalk
Co. Louth
A91 YH90,
Ireland
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PAYE
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Social Welfare
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Self Employed
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Student
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Retired
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Emp Code
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credit union id
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Loan Type

Phone	(042) 93 35489
Website	www.dundalkcu.ie
In branch	Market Street, Dundalk Co. Louth A91 YH90, Ireland

Step 1 of 10

Contact Details

Personal Details

Your Employment Details

Application Details

Your Income

Your Outgoings

Declarations and Consents - please read carefully before submitting

Authorisation and Application

Data Processing

Credit Checks

Receive Certain Notices Electronically

Marketing Consent