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1st CCU
1st Community
Credit Union

SPARTA
1000 West Wisconsin
Street
PO Box 167
Sparta, WI 54656

Phone: 608-269-8121
Fax: 608-269-8120
Toll-Free: 888-706-1228

SPARTA HOURS
Lobby: M-W 8:30-5:00
            Th-F 8:30-5:30
            Sat 8:00-11:30

Driveup: M-F 7:30-5:30
             Sat 8:00-11:30
*ATM available 24/7


WEST SALEM
1410 Hwy 16
PO Box 913
West Salem, WI 54669

Phone: 608-786-2420
Fax: 608-786-1025
Toll-Free: 888-706-1228

WEST SALEM HOURS
Lobby: M-Th 8:30-5:00
                Fri 8:30-5:30
          Closed Saturday

Driveup: M-F 7:30-5:30
              Sat 8:30-Noon
*ATM available 24/7



Loan Application

INSTRUCTIONS
You may apply for individual or joint credit, but check only one of the following boxes.
Individual Credit - Unmarried Applicant. Complete only the left hand columns on both sides of this form and other sections as they apply.
Individual Credit - Married Applicant. If both you and your spouse are residents of Wisconsin, complete both the left and right hand columns. If either you or your spouse are not Wisconsin residents, complete only the left hand column.
Joint Credit - With your Spouse. Complete the left and right hand columns on both sides of this form and other sections as they apply.
Joint Credit - With another applicant or
cosigner who is not your spouse
.
Each of you must complete a separate application. If both you and your spouse are Wisconsin residents include information about your spouse in the right hand column.
NOTICE TO MARRIED APPLICANT: No provision of a marital property agreement, a unilateral statement under Wis. Stat. sec. 766.59 or a court decree under Wis. Stat section 766.70 adversely affects the interest of the credit union unless prior to the time the credit is extended, the credit union is furnished with a copy of the agreement, statement or decree, or has actual knowledge of the adverse provision when the obligation to the credit union is incurred.

LOAN
I/We Hereby apply for:
A direct loan of     no. of payments:     amount of payments:    
  purpose of direct loan 
A Credit line of for purpose of
Credit Insurance Information: Credit life or credit disability insurance is not required to obtain credit. If you wish to be considered for credit insurance on the loan for which you are applying, please complete the information below.
I Do   Do not want credit disability insurance for myself
I Do   Do not want joint credit disability insurance
I Do   Do not want credit life insurance for myself
I Do   Do not want credit life insurance

Note: This is not a binding contract for credit insurance.
Collateral:Titled in the name of:Address:Insured by:
Collateral:Titled in the name of:Address:Insured by:

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