www.ivcu.com
Phone (815) 224-2667 • Fax (815) 224-2691

Peru
1311 Shooting Park Road • Peru, IL 61354

Princeton
200 Ace Road • Princeton, IL 61356

Application Type Individual * Joint

Amount Requested*

For How Long
(# of months or payment amount)

Purpose:(Home Impr., Auto, Bill Payer, etc.)*

Collateral Offered* Home Real Estate Vehicle Unsecured

Payment Requested

Interest Rate

Credit Union Account # *

Are you a new member to the credit union New Member

APPLICANT INFORMATION

Email*

Cell Phone*

Work Phone*

Can you accept calls at work? (I cannot accept calls at work)

Home Phone*

Name*

Social Security Number*

Date of Birth*

Current Address/City/State/Zip *

Years/Months*

Residence*

Own

Live with Parent(s)

Rent

Other

Description of other residence type

Monthly Rental or Mortgage Payment*

Market Value of Real Estate Owned

Balance Owed on all Real Estate

Current Employer*

City/State*

Annual Gross Income*

Position/Job Title*

Work Phone *

Supervisor's Name

Start Date*

Previous Employer
If Less Than Two Years

City/State

Occupation

How Long?

OTHER INCOME INFORMATION

*Alimony, child support, or separate maintenance income need not be revealed if you do not wish it to be considered as a basis for repayment.

Source/Type of Other Income

City/State

Phone Number

Years/Months

Annual Gross Income (Must be Verifiable)

CO-APPLICANT INFORMATION

Name*

Social Security Number*

Date of Birth*

Current Address/City/State/Zip*

Is your address the same as the applicant? Same as applicant

Years/Months*

Home Phone Number*

Residence*

Own

Live with Parent(s)

Rent

Other

Description of other residence type

Monthly Rental or Mortgage Payment*

Market Value of Real Estate Owned

Balance Owed on all Real Estate

Current Employer*

City/State*

Annual Gross Income*

Position/Job Title*

Work Phone*

Supervisor’s Name

Date Employed*

Previous Employer

City/State

Occupation

How Long?

OTHER INCOME INFORMATION

*Alimony, child support, or separate maintenance income need not be revealed if you do not wish it to be considered as a basis for repayment.

Source/Type of Other Income

City/State

Phone Number

Years/Months

Annual Gross Income (Must be Verifiable)

SIGNATURE CERTIFICATION

Applicants' Initials*

Date*

The information provided on this application is true and correct.

Can we contact you via email and text message Yes,

I allow Illinois Valley Credit Union to contact me via email and send a text to my phone.

No,

Please do not send me e-mail messages regarding credit union news or specials.

30-Day Free Look Offer: A SAFETY NET, WHEN YOU NEED IT MOST.

MEMBER'S CHOICE Credit Disability and Credit Life Insurance work in two different ways. You and your family may not have to make loan payments if you’re totally disabled due to a covered injury or illness.* It may help pay your loan until you’re no longer totally disabled, or in the event of your unexpected death, it may help pay off the loan.* Savings, salary, or payoffs from other life insurance may be used for other important things, giving your family financial freedom when they need it most.
*Up to your policy maximums; per terms and conditions and exclusions on your Credit Insurance Certificate.