Big Dutch Fleet Credit Union

Home Equity Loan Application

Borrower:______________________Date of Birth _______Member#_______SSN#___________

Co-Borrower_______________________DOB_________Member#_______SSN#___________

Telephone#:Home_____________ Work:______________

Debit for Appraisal: Checking __  Savings __   (estimated to be $300.00)

Loan Amount Requested: _________________ Refinance ___ Purchase ___

Estimated value of Subject Property: _____________

Subject Property Address: ________________________________________________________

Present Address: _______________________________________________________________

Own ___ Rent ___    Years:___

Present Mortgage Payment: _____________ Present Balance: ___________

Lien Holder :__________________ Present Escrow Payment: _________

Employment Information

Borrower: ( work name,address,phone) __________________________________________________

Position____________________________ Years____ Pay: ___________

CoBorrower: (work name,address,phone) ________________________________________________

Position____________________________Years____Pay ____________

I  give Big Dutch Fleet Credit Union permission to run a credit report on me for review with this

application.  ________________________borrower __________________________co-borrower

Date: _____