Loan Application Form for New Members

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Loan Application Form for New Members Please answer all questions as incomplete applications will be returned. Along with this application, you will need to provide statements covering three full months for all bank accounts that you have and proof of income (payslips or benefits letters) if this is not clearly shown on the bank statements. Personal Details Surname First Name(s) Have you ever changed your name (i.e. marriage)? Office Use Membership Number Title Mr / Mrs / Ms / Miss / Other: What was your previous name? Date of Birth When did you change your name? Nationality Contact Telephone (Home) Email Postcode (Mobile) Housing Details - Are you a Homeowner Living with Parents Private Tenant Housing Association or Council Tenant Other (Please specify) Name of Landlord (If applicable) Do you live: Alone / Alone with child(ren) / With husband, wife or partner / With husband, wife or partner and child(ren) / Sharing with family or friends How many dependents aged under 16 do you have? How many dependents aged between 16 and 18 do you have? Gloucestershire Credit Union Ltd, Gloucester Library,, Company Registration No. IP00682C. Version E May 18

Length of Time at Present Years Months If you have lived at your current address for less than 5 years please list all the addresses you have lived at in the previous 5 years From To Tax Information National Insurance Number Do you pay tax in any other countries? Yes No If Yes, please declare any tax jurisdictions other than the UK in which you are considered resident for tax purposes Country / Tax Jurisdiction Tax Information Number Loan Requested Please refer to the leaflet Getting the right Loan from Gloucestershire Credit Union for guidance on applying for a loan Amount of Loan Requested I will repay this loan in instalments of Per Week / Fortnight / Four weeks / Month Amount to be saved with each repayment You must save at least 10% of each loan repayment Purpose of Loan Page 2

Bank Nomination We will normally only pay withdrawals from your credit union account, and loan advances, by direct transfer to your bank account. Please nominate a bank account to which these transfers will be made:- Bank Sort Code Do you have an overdraft agreed with your bank? Account Name Account Number Agreed overdraft Limit Employment Please complete this section if you have paid employment Employer s Name Employers (Only required if you do not live in Gloucestershire) Job title Is your job Permanent / Fixed term / Temporary / Agency / Self employed Time with Employer Years Months Average Hours Worked How often are you paid Weekly, Every two weeks, Every four weeks / Monthly Hours Per Week When is your next pay day? Page 3

Income and Expenditure Please complete this section fully. Income Salary / Wage (after tax and NI)_ Per week / month Pension Per week / month Benefits Per week / month Total Income (I) Per week / month Expenditure Section 1 - Regular Outgoings Mortgage or Rent Per week / month Utilities (gas, electric & water) Per week / month Telephone (incl mobile phone and internet) Per week / month TV licence (incl SKY or cable) Per week / month Council Tax Per week / month Home and/or Contents Insurance Per week / month Car (Tax, Insurance, Fuel & MOT) Per week / month Other Travel (ie. Bus or Train) Per week / month Food Shopping Per week / month Personal Shopping Per week / month Health (ie, prescriptions or dental plan) Per week / month Holidays Per week / month Money Sent Home or to Relatives Per week / month Other (not covered in above) Per week / month Total Regular Outgoings (1) Per week / month Page 4

Section 2 Priority Debts Type of Debt How Much do How Much are you Owe the Repayments Mortgage or Rent Arrears Secured Loans Council Tax Tax Utility Bills Court Fines Total Priority Debt (2) Section 3 Non-Priority Debts ie Non-secured loans, credit cards, store cards or hire purchase Name of Creditor How Much do How Much are you Owe the Repayments Total Non-Priority Debt (3) Total Expenditure (E) Add the totals of Sections 1, 2 and 3 above Per week / month Total Income (I) Total Expenditure (E) = Spare Money If your spare money is more than the amount that you have asked for then why do you need the loan? Please re-check the information provided. Page 5

Health Declaration Gloucestershire Credit Union insures all loans on behalf of our members so that the balance will be paid in the event of death. You must tell us the address of your doctor s surgery. Doctor s Name and Declaration In accordance with the principles of the General Data Protection Regulations, Gloucestershire Credit Union is data controller of the information you have provided on this form. We will use your personal details for the purposes of managing and processing your account with the Credit Union. Further information about how we store and process your data can be found on our website. Do you have any County Court Judgements? Have you ever been declared bankrupt or are you in the process of bankruptcy? Are you, or have you ever been, the subject of an IVA (Individual Voluntary Arrangement) or DRO (Debt Relief Order), or are you in the process of obtaining such an order? Are you currently using the services of a Debt Management Organisation? I understand that some of my savings in Gloucestershire Credit Union will be attached to my loan and that I will not be able to withdraw these funds until the loan has been fully repaid. The value of shares attached will be clearly stated on the loan agreement. I understand that if I do not make the agreed repayments of this loan then Gloucestershire Credit Union may take any legal measures it deems necessary to recover monies owed to it. This may include, but is not limited to, applying to the DWP to have deductions made from any benefits that you receive. I confirm that I have read and accept the standard loan conditions given below. I agree to abide by the rules of the credit union and confirm that the information given above is true and complete and is an honest reflection of my current and foreseeable financial circumstances. I authorise the Gloucestershire Credit Union to make any enquiries it deems necessary in connection with this application. This may include referring to a credit reference agency for credit and identification purposes and such agencies may keep a record of enquiries on my file. Page 6

Marketing Preferences I wish to receive annual statements and other formal notifications from the credit union via email. (Notices not sent by email will be sent by post.) I wish to receive the Gloucestershire Credit Union newsletter by E-mail I wish to receive the Gloucestershire Credit Union newsletter by post I wish to receive information about Gloucestershire Credit Union's products and services by E-mail I wish to receive information about Gloucestershire Credit Union's products and services by post I acknowledge receipt of the information sheet giving details of the deposit guarantee scheme (FSCS) which protects any savings I may have in Gloucestershire Credit Union Signature Date Once completed, please bring or send this form to our office in Gloucester Library or one of our service points, (see /opening-times/ for details of our service points and opening times). There is a one-off fee of 5 to join Gloucestershire Credit Union, this is to cover the costs of setting up a new account and you must also deposit at least 5 into your account. Before we can open your account we need to verify your identity and address. We will contact you about this once we have considered your application. For Office Use Only: Form 3/ Date Received Loan Number Date Considered Loan Committee 1) 2) 3) Members Present Loan Approved Or Declined Identity documents copied and checked by: HMRC Sanctions List checked by: Payment Made By Payment Date Cheque Number Or BACS Reference Page 7

Beneficiary Nomination Gloucester Library I (full name)... Of (full address)... Being a proposed member of the Gloucestershire Credit Union hereby nominate the following named people as beneficiary/ies to whom shall be transferred such monies within the credit union as may be mine at the time of my death whether in shares or otherwise. 1) Name Postcode 2) Name Postcode 3) Name Postcode 4) Name Postcode Signed Date Witnessed by (full name) Witness Signature Date The witness should not be a beneficiary Page 8

Membership Loan Terms and Conditions Loans will only be granted to credit union members over 18 years of age. Savings It is a condition of Savers Loans that you have been saving regularly for a period before the loan is granted; a poor or erratic savings record may result in your loan application being turned down. It is a condition of CURight Loans that you save an amount at least 10% of your loan repayments. With other loans you are encouraged to save at the same time as paying back your loan. Some of your shares will be attached to provide security for your loan. This means that you will not be able to withdraw these shares. The value of the shares attached will be stated on the loan agreement. Should you default on any repayment of the loan, all of your shares up to the outstanding loan balance will be attached to the loan and you will not be able to withdraw these. Loans and Repayments Details of the loans available are given in our lending policy available from the office or the on the website. The maximum loan available is: Savers Loan - 10,000 over 60 months CURight Loan - 2,500 over 24 months. Check with the Credit Union for current maximum loan you can apply for. Loans are repaid weekly, fortnightly or monthly over the term agreed in the loan agreement. Credit Committee The Credit Committee, appointed by the members at the Annual General Meeting of the Credit Union, will assess your application and if necessary they may ask for further information and/or an interview. The Credit Committee's decision is final. If your application is rejected or if the Committee offer a smaller loan you will be told the reasons. Once the Credit Committee have met and agreed the loan, it takes about a week to process. Payment of the Loan Payment of the loan will not be made until you have signed a loan agreement form. Payments can only be made by Bank Transfer (BACS). Interest Interest is charged daily on the outstanding loan balance. For Savers Loans the interest rate is 0.6% to 2% per month (APR 8.73% to 26.82%) For SaversPlus Loans the interest rate is 0.275% to 0.4% per month (APR 3.35% to 4.91%) For CURight Loans the interest rate is 2% to 3% per month (APR 26.82% to 42.58%) Interest is calculated upon the reducing balance of your loan. The quicker you are able to repay your loan, the less interest you will be charged. There are no penalty fees for paying off your loan early. Loan Arrears Although the Credit Union will do what it can to assist members who have genuine reasons for falling behind with repayments it should be noted that all legal measures will be taken to recover the loan arrears. If your circumstances change, and you have difficulty meeting the repayments of your loan, please contact the Credit Union as quickly as possible. We will try to help our members who have run into difficulties, but it becomes more difficult to help if arrears have been allowed to mount up without contacting us promptly. You may be charged the cost of recovery action taken by the credit union if you do not repay your loan as agreed. Recovery from Benefits If you default on any repayments of your loan then Gloucestershire Credit Union may pass information about you and your loan to the Department of Works and Pensions (or its successor) for their consideration to make deductions from any benefits that you are or will become entitled to. Page 9

How we will Share your Personal Information with Credit Reference Agencies In order to process your application, we will perform credit and identity checks on you with one or more credit reference agencies ( CRAs ). To do this, we will supply your personal information to CRAs and they will give us information about you. This will include information from your credit application and about your financial situation and financial history. CRAs will supply to us both public (including the electoral register) and shared credit, financial situation and financial history information and fraud prevention information. We will use this information to: Assess your creditworthiness and whether you can afford to take the product; Verify the accuracy of the data you have provided to us; Prevent criminal activity, fraud and money laundering; Manage your account(s); Trace and recover debts; and Ensure any offers provided to you are appropriate to your circumstances. We will continue to exchange information about you with CRAs while you have a relationship with us. We will also inform the CRAs about your settled accounts. If you borrow and do not repay in full and on time, CRAs will record the outstanding debt. This information may be supplied to other organisations by CRAs. When CRAs receive a search from us they will place a search footprint on your credit file that may be seen by other lenders. The identities of the CRAs, their role also as fraud prevention agencies, the data they hold, the ways in which they use and share personal information, data retention periods and your data protection rights with the CRAs are explained in more detail on our website. This information is also accessible from each of the three CRAs visiting any of these three links will also take you to the same CRAIN document: Callcredit www.callcredit.co.uk/crain Equifax www.equifax.co.uk/crain Experian www.experian.co.uk/crain. Page 10