Members with automatic payment and at least two years of continuous employment with the same employer qualify for a $300 loan for 4 months at 17.95% APR*. __________________ Members with automatic payment and at least five years of continuous employment with the same employer qualify for a $500 loan for 6 months at 17.95% APR*. __________________ Members with automatic payment and at least ten years of continuous employment with the same employer qualify for a $1,000 loan for 9 months at 17.95% APR*.    Complete the opposite side of this flyer. Submit the completed form to Chesterfield Federal Credit Union. Information must be provided in full for consideration. A representative will contact you if proof of employment is necessary and to set up an appointment to close your loan between November 12th - November 26th! Applications must be submitted by November 1st * Annual Percentage Rate. Loans will be closed on an appointment-only basis. Applications must be received by November 1st, 2014 to be considered. Limit one loan per member. Rate is fixed at 17.95%APR. Standard monthly payment at 17.95% is $77.78 for the $300 loan, $87.66 for the $500 loan and $119.40 for the $1000 loan. Loan approval is based on length of employment. Members with existing delinquent loans or accounts, or loans or accounts which have been more than 30 days delinquent anytime during the past 6 months are not eligible for approval. Applicant must have been an active credit union member for at least six months. Other sources of income may be considered. Accounts must have not been more than 10 days negative in the last 30 days, excluding Overdraft Privilege activity. Member must not currently be involved in bankruptcy, or have an existing workout loan. Please allow 10 business days for processing after submitting your application. Other restrictions may apply. Holiday Help Loan Application Member Account Number ______________________________ Requested Loan Amount: $300 $500 $1000 Name of applicant _______________________________________________________________________________________________ First Middle Initial Last Current address__________________________________________________________________________________________________ Street City At this address since________________ State Monthly Rent or Mortgage $_______________ Primary Phone _________________________  Home  Mobile Zip Circle One: Rent Mortgage  Work Nearest Relative Not Living With You ______________________________________________________________________________ First Last Relationship Home Phone __________________ Address__________________________________________________________________________ Street City Current Employer _______________________________ Start Date: ___________________ State Zip Position _________________________ Employer Address _______________________________________________________________________________________________ Street City Work Phone ___________________________________ State Zip Gross employment income $_________________________ year / month circle one Other income: $______________ year / month Source _____________________________________________________________ Note: Alimony or child support need not be revealed if you do not want it considered. Automatic Payment Preference: Payroll Deduction Automatic Transfer (Transfer Date __________) Is your payroll currently deposited automatically to Chesterfield FCU: Yes No  Preferred Loan Closing Location:  Chesterfield Courthouse Brandermill Midlothian Village Are you currently involved in a bankruptcy: Yes No  I understand that normal lending guidelines are not used as a factor for determining approval of this application. I also understand that paying this loan as agreed and in full does not guarantee approval of future loan requests. Normal lending guidelines will apply to future loan applications. By signing below, I certify that all the information on this application is true and correct and represents my current financial condition. _________________________________________________________________________________ Signature of Applicant ____________________________ Date FOR CREDIT UNION USE ONLY—DATE AND INITIAL AS COMPLETED Application Received No Bankruptcy Verified per Voucher Total Years of Services Verified No 30+ Day Delinquent Share / Loan Ver. No 10-Day Neg. Share In Last 30 Days Verified No Workout/ Modified Loans Application Entered in LOS ___________________ Date: ___________________ Date: ___________________ Qual. Amount: ___________________ Date: ___________________ Date: ___________________ Date: ___________________ Date: No Bankruptcy Confirmed Via CBI Length of Service & Employment Verified Closing Scheduled For: Approved Amount Final Account Check by Prior To Close Loan Closed, Documents Signed Stacked & Cross Sold ___________________ Date: ___________________ Date: ___________________ By: $300 $500 $1000 ___________________ Date: ___________________ Date: ___________________ Date: