1481 Harlem Road Cheektowaga, NY 14206 • Phone: (716) 897-2383 • Email: memberservices@bufconfcu.com

Loan Information
Primary Information

Buffalo Conrail FCU Loan Application

Will this be a Single or Joint Application?

No dashes, spaces, or parentheses

Repayment Method

Personal Information

Primary Applicant - Personal information

No dashes, spaces, or parentheses

No dashes, spaces, or parentheses

Complete for joint credit, secured credit, or if you live in a community property state *

Employment information

Reference

No dashes, spaces, or parentheses

Additional Questions

Are you a US citizen or permanent resident alien? *

Do you have any outstanding judgments? *

Is your income likely to decline in the next two years? *

Are you a co-maker, co-signer, or guarantor on any loan not listed? *

Have you filed for bankruptcy or had a debt adjustment plan confirmed under chapter 13? *

Joint Information

Joint Applicant - Personal information

No dashes, spaces, or parentheses

No dashes, spaces, or parentheses

No dashes, spaces, or parentheses

Complete for joint credit, secured credit, or if you live in a community property state *

Employment information

Reference

No dashes, spaces, or parentheses

Additional Questions

Are you a US citizen or permanent resident alien? *

Do you have any outstanding judgments? *

Is your income likely to decline in the next two years? *

Are you a co-maker, co-signer, or guarantor on any loan not listed? *

Have you filed for bankruptcy or had a debt adjustment plan confirmed under chapter 13? *

Agree and Submit

Assets and Debts

List your assets.


Pledged as collateral for another loan?

Owner of asset


Pledged as collateral for another loan?

Owner of asset


Pledged as collateral for another loan?

Owner of asset


Pledged as collateral for another loan?

Owner of asset


List your debts.

Debt 1 Owner:



Debt 2 Owner:


Debt 3 Owner:


Debt 4 Owner:


Debt 5 Owner:


Debt 6 Owner:

Disclosure and Agreement to Terms

I hereby certify that all information contained in the application is furnished for the purpose of obtaining the loan requested herein and is true to the best of my knowledge and belief. I further certify that no consideration has passed or will pass from me, as borrower, to an endorser for his endorsement or to co-maker for his/her signature. You are authorized to check my credit and employment history and to answer questions about your credit experience with me. I have assisted the Credit Union in the preparation of this application; I have provided the Credit Union with all of the information contained therein; I hereby certify that this loan application is truthful and complete to the best of my knowledge and that I have read the entire completed application before signing same.

Do you agree with the above terms and conditions? *

Co-Applicant

Do you agree with the above terms and conditions? *