Social Security Credit Union Online Loan Application
205-323-7028 | 888-306-6299 | PO Box 937, Birmingham, AL 35201 | 1200 Rev Abraham Woods Jr. Blvd, Birmingham, AL 35285
Type Requested:*
Loan Amount Requested:*
Purpose of Loan: *
Repayment Method:
Applying for individual or joint credit?*
Marital Status:
PRIMARY APPLICANT Member Number:*
Full Name:*
Social Security Number:*
Date of Birth:*
Number of Dependents:
Ages of Dependents:
Home Phone Number:
Work Phone Number:
Cell Phone Number:
Email Address:
Drivers License Number:
Drivers License State:
Mother's Maiden Name:
Home Address:*
City:*
State:*
Zip:*
Time at Current Residence:
Residence Type:
Monthly Payment $:
Present Employer:*
Employer Phone:
Employment Status:
Job Title:
Job Start Date:
Gross Salary $:
Other Income:
Other Income Source:
Co-Applicant Member Number:
Co-Applicant Full Name:
Co-Applicant SSN:
Co-Applicant Date Of Birth:
Co-Applicant Number of Dependents:
Co-Applicant Age of Dependents:
Co-Applicant Home Phone:
Co-Applicant Work Phone:
Co-Applicant Cell Phone:
Co-Applicant Email Address:
Co-Applicant Drivers License #:
Co-Applicant Drivers License State:
Co-Applicant Home City:
Co-Applicant Home State:
Co-Applicant Home Zip:
Co-Applicant Time at Current Residence:
Co-Applicant Time at Current Residence:
Co-Applicant Monthly Payment $:
Co-Applicant Present Employer:
Co-Applicant Employer Phone Number:
Co-Applicant Employment Status:
Co-Applicant Employer Job Title:
Co-Applicant Employment Status:
Co-Applicant Gross Salary $:
Co-Applicant Other Income:
Co-Applicant Other Source:
REFERENCE (Nearest relative not living with you):
REFERENCE Relationship to You:
REFERENCE Phone Number:
REFERENCE Address:
REFERENCE City:
REFERENCE State:
REFERENCE Zip:
Monthly Debts:
Contact Preference:
Special Comments:
Loan Term Requested:*
Co-Applicant Home Address:
SIGNATURE