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About Your Additional Applicant

Suffix (Jr., Sr., etc.)

SSN

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Your Social Security Number (SSN) is used for identification purposes and to determine your account opening eligibility.

Date of Birth

Member Number

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Reference Information

First Name

Last Name

Phone

(xxx) xxx-xxxx

Relationship

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Address

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Use different address for mailing

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Address

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State

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Financial Information

^§Alimony, child support and separate maintenance income need not be revealed if you do not wish to have them considered as a basis for repaying this obligation.

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Protection that Matters

Credit Life and Credit Disability Insurance, underwritten by CMFG Life Insurance Company, is available for most loan products

Would you like more information about protecting your loan payment or balance with Credit Life and Credit Disability Insurance from your lender?

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Debt Protection is available with most loans by the credit union. It is designed to cancel your loan payment or balance, up to the contract maximums, if a protected life event occurs. Available package options will include one or more of the following life events: Life, Disability or involuntary unemployment.

Would you like more information about protecting your loan payment or balance with Debt Protection from your lender?

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MEMBER’S CHOICE™ Guaranteed Asset Protection (GAP) is an optional protection product made available by the credit union. In the event of a total loss, GAP is designed to cancel the difference between your primary insurance settlement and the outstanding loan balance, up to the contract maximums. For more information, call or visit the credit union.

Would you like more information about protecting your loan with GAP from your lender?

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Mechanical Repair Coverage can help you limit the cost of covered vehicle breakdowns.

Would you like more information about Mechanical Repair Coverage from your lender?

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