QR RFID – 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 Country

Your Employment Details

Employment Status

Which Institution / College do you attend?

What is your trading name?

In which sector does your business operate?

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

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 County 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

Hidden

Monthly Repayment

Hidden

fortnightly repayment

Hidden

weekly repayment

Repayment Amount

Repayment Method

Loan Funds Payout Method

Your Income

Monthly Take Home Pay

After Tax & Deductions

Are you in receipt of social welfare?

Yes
No

How much social welfare do you recieve?

I have an additional regular monthly income I'd like to add

No
Yes

Additional Monthly Income

This can be rental income, a pension etc.

I have a further monthly income I'd like to add

No
Yes

Additional Monthly Income

Your Spouse's Income

Spouse Income

Spouse / Partner - Monthly Take Home Pay

After Tax & Deductions

Is your Spouse / Partner in receipt of social welfare?

Yes
No

How much social welfare does your Spouse / Partner recieve?

Does your Spouse / Partner have an additional regular monthly income you would like to add

No
Yes

Additional Monthly Income

This can be rental income, a pension etc.

Does your Spouse / Partner have a further monthly income you would like to add

No
Yes

Additional Monthly Income

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 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

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.

Warning: If you do not meet the repayments on your loan, your account will go into arrears. This may affect your credit rating, which may limit your ability to access credit in the future.

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

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

By ticking the box I/we authorise the Credit Union to conduct additional credit verifications and assessments as necessary for the purposes of considering my/our application in accordance with the Credit Checks Notice.

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:

Select All
Email
Post
Text Message
Phone

No, I do not want to be contacted

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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

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