pdf – Dundalk Credit Union

Personal Details

Date of Birth

Title

Prefix

Marital Status

What is your maiden name?

If applicable

Please enter your home address

Address Line 1 Address Line 2 Town County Eircode Country

Living Situation

Home Owner
Tenant
Living with Parents

Property Type

Number of Residents Living At This Address

Years living at this address

If resident for less than 3 years please supply previous address

Address

Address Line 1 Address Line 2 Town County

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 City State / Province / Region Country

Time in current Employment

If you wish to have your spouse/partners income take into consideration for this application. Please tick here to confirm you have your spouse/partners permission to do so.

Yes

Spouse Employment Details

Spouse Details

Prefix First Last

Spouse / Partner Employment Status

Employment Type

Employer Name

Employer Address

Street Address Address Line 2 City State / Province / Region Country

Position Held

Time in current Employment

Application Details

Loan Application Amount

Loan Purpose

Other loan purpose

Term of Loan (in years)

Duration

Repayment Frequency

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Monthly Repayment

This field is hidden when viewing the form

fortnightly repayment

This field is hidden when viewing the form

weekly repayment

Repayment Amount

Repayment Method

Loan Funds Payout Method

Your Income

Monthly Take Home Pay

After Tax & Deductions

Social Welfare

Monthly Rental Income

If Applicable

Other Monthly Income

After Tax & Deductions

Your Spouse's Income

Spouse Income

Spouse / Partner - Monthly Take Home Pay

After Tax & Deductions

Social Welfare

Monthly Rental Income

If Applicable

Other Monthly Income

After Tax & Deductions

Financial Details

Please consider any Mortgages, Loans, Credit Cards, Overdrafts etc.

Choose Borrowing Type

Current Loan Balance

Name of Lender

Monthly Repayment

Drawdown/Start Date

Term (in years)

Declarations, Authorisations and Consents

Below, the terms ‘we’ or ‘us’ or ‘the Credit Union’ refer to Dundalk Credit Union Limited. 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 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

Yes
No

Please provide details:

Authorisation and Application

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 Agreement.

I consent and agree to the above Authorisation and Application

By ticking the box I consent to receiving Notices electronically

By ticking the box I confirm and acknowledge the data processing agreement

By ticking the box I confirm and acknowledge the Credit Reference Searching and Reporting agreement

From time to time the Credit Union would like to notify you of promotional offers, competitions and to provide information on our products and services. The data supplied in the Application Form may be used to contact you by telephone, email, text or post. 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;

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

By ticking this box I consent to receiving the above marketing communications

Personal Loan Enquiry with Application ONE PAGE

Contact Details

Personal Details

Personal Details

Your Employment Details

Spouse Employment Details

Application Details

Your Income

Your Spouse's Income

Spouse Income

Financial Details

Declarations, Authorisations and Consents

Authorisation and Application