Credit Application › The Union Bank Co.

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Credit Application

Reason For Loan * Amount Requested *

Individual Application Information

Last Name *

First Name *

Middle Name Name *

Date of Birth *

Phone Number *

Last 4 Digits of Social Security # *

Current Address *

City *

State *

Zip Code *

County *

Do you own OR do you rent? * Own Rent

How Long *

Value of Home

Employer *

Time at Employer *

Gross Monthly Income *

Sources of Other Income

Amount Per Month *

Co-Borrower Information

Name

Date of Birth

Last 4 Digits of SSN

Gross Monthly Income

Current Accounts

Please list your current checking and saving accounts, the name in which the account is carried, and what bank it is with.

Checking Account(s)

Checking Account One

Checking Account Number *

Name in Which Account is Carried *

Bank *

Checking Account Two

Checking Account Number *

Name in Which Account is Carried *

Bank *

Checking Account Three

Checking Account Number *

Name in Which Account is Carried *

Bank *

+ Add Another Checking Account

Savings Account(s)

Savings Account One

Savings Account Number *

Name in Which Account is Carried *

Bank *

Savings Account Two

Savings Account Number *

Name in Which Account is Carried *

Bank *

Savings Account Three

Savings Account Number *

Name in Which Account is Carried *

Bank *

+ Add Another Savings Account

Credit Check Authorization

Do you authorize us to pull you and your co-borrower’s credit reports in order to pre-qualify you for a loan? * (If so, please provide social security numbers and date of births)

Yes No

* Indicates required field

Equal Housing Lender

Equal Housing Lender

The Union Bank Co.

105 Progressive Drive
Columbus Grove, OH 45830
(800) 837-8111
Routing Number - 041213759

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Lost/Stolen Card

The Union Bank Co. NMLS: 433131