VISA Application

* Required Fields

Will there be a co-applicant on this application?
Yes
No
* Type of VISA requested
* Account Type
Credit Limit Requested
Primary Applicant
* First Name
* Last Name
* Street Address
* City
* State
* Zip Code
* Home Phone
( * Home Phone 1 ) * Home Phone 2 - * Home Phone 3 ext * Home Phone Extension
* Email Address
* Social Security Number
* Birth Date
* Birth Date Month / * Birth Date Day / * Birth Date Year
Current Employer
Phone Number
( Phone Number 1 ) Phone Number 2 - Phone Number 3 ext Phone Number Extension
Start Date
Job Title
Gross Annual Income
Co-Applicant (if applicable)
First Name
Last Name
Street Address
City
State
Zip Code
Home Phone
( Home Phone 1 ) Home Phone 2 - Home Phone 3 ext Home Phone Extension
Email Address
Social Security Number
Birth Date
Current Employer
Phone Number
( Phone Number 1 ) Phone Number 2 - Phone Number 3 ext Phone Number Extension
Start Date
Job Title
Gross Annual Income
Debts / Monthly Payments
1 - Type of Payment
1 - Amount (Monthly)
2 - Type of Payment
2 - Amount (Monthly)
3 - Type of Payment
3 - Amount (Monthly)
* Are you interested in having your loan protected?
Yes
No
If you answer "yes", the credit union will disclose the cost to protect your loan. The protection is voluntary and does not affect your loan approval. In order for your loan to be covered, you will need to sign a seperate application that explains the terms and conditions.
In addition to Rent/Mortgage, list all other debts (for example, auto loans, credit cards, second mortgage, home association dues, alimony, child support, child care, medical utilities, auto insurance, IRS liabilities, etc.). Please use a separate line for each credit card and auto loan.

Please note: Income verification is required; other information may be required.

Alimony, child support, or separate maintenance income need not be listed unless you choose to have such income considered regarding extension and repayment of the credit requested.
Consent To Over-The-Credit Limit Coverage
Unless you tell us otherwise, we will decline any transaction that causes you to go over your credit limit. If you want us to authorize these transactions, you can request over-the-limit coverage. If you have over-the-limit coverage and you go over your credit limit, we will charge you a fee of $15.00. You will only pay one fee per billing cycle, even if you go over your limit multiple times in the same cycle. Even if you request over-the-limit coverage, in some cases we may still decline a transaction that would cause you to go over your limit, such as if you are past due or significantly over your credit limit. If you want over-the-limit coverage and to allow us to authorize transactions that go over your credit limit, please:

Call us at (906)228-9850; visit www.marquettecomm.org; or Check the box below
* Over-The-Credit-Limit-Coverage Consent
I want over-the-limit coverage. I understand that if I go over my credit limit I will be charged a fee of $15.00. [I have the right to cancel this coverage at any time.]
I do NOT want over-the-limit coverage. I understand that transactions that exceed my credit limit will NOT be authorized.
I certify that statements on this application are true and complete. I authorize any person, association, firm, or corporation to furnish, on request of this Credit Union, information concerning me or my affairs.

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Primary Applicant

Co-Applicant (if applicable)