Loan Application Form

New or Existing Member If you are already a member of LASER Credit Union please enter your member number, or leave blank to apply for membership now

First Loan or Top Up Loan

Is this your first loan with us or are you applying for a top up loan?

First Loan Top Up Loan

Please note: You can only apply for a top up loan every 16 weeks.

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Eligibility

Do you live or work in South Yorkshire or North East Derbyshire?

Are you a member or employee of:

Community

Chamber of Commerce

Press Association

UNISON (In Yorkshire & Humberside)

None

LASER Credit Union offers services to anybody who lives or works in South Yorkshire or North East Derbyshire. We also offer services to members or employees of the organisations shown above. If you do not meet our qualifying criteria, please apply to your local credit union, which can be found at www.findyourcreditunion.co.uk

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Full Name:

Title

First

Last

Previous Name:

Title

First

Last

Partner's Name:

Title

First

Last

Current Address:

Postcode:

Time at this Address:

Years

Months

Other Info

Date of Birth: (dd/mm/yyyy)

NI Number:

Child Benefit Number (if applicable):

Nationality:

Contact Info

Phone:

Mobile:

Email:

Highlighted fields are required.

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Please give details of all previous addresses within the last 3 years

Previous Address:

Postcode:

Time at this Address:

Years

Months

Add another address

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Form of Nomination:

In the event of my death I would like my savings held by the credit union to be passed onto:

Name:

Title

First

Last

Address:

Tick if the same as your address:

Postcode:

Telephone:

Relationship to You:

If you have a will it could supersede this nomination.

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How did you hear about us?

Declaration:

I apply for membership of LASER Credit Union and declare that the information given by me on this form is true and correct to the best of my knowledge. I agree to abide by the rules of the credit union.

I Agree

What Next?

LASER will perform an online check on your identity and address verification check. If you cannot be identified in this way, we will need you to provide us with the following: Proof of identity and verification of address.

You will need to provide us with proof of identity.

Passport
Driving Licence
Birth Certificate
Medical Card
Bus Pass
ID Card

You will also need to provide us with proof of address.

Bank Statement
Child Benefit Letter
Other Benefit Letter
Utility Bill

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Savings Accounts Benefits of Membership

Membership of LASER Credit Union automatically gives you a Membership Savings Account (or Children's Savings Account) but you can also apply for additional savings accounts here:

Membership Savings Account

Premier Savings Account

Premier Deposit Account

Christmas Club Savings Account

LASER Credit Union currently offers the following services to Community members, apply for one or both:

Community Bank Account

Community Savings Account

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Order Form

Item	Ref (Optional)	Quantity	Options	Cost £












Total:

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Order Confirmation

Please note we must receive payment in full before your goods can be ordered.

How will you pay:

You can make a BACS transfer into your savings account by using the details below. Please make sure you quote your order reference number.

Co-operative Bank 27 Bridgegate Rotheram S60 1SN	Account name	LASER Credit Union
	Account number	67008168
	Sort Code	08 92 50

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Would you like to apply for a loan?

You can finish your application here or continue on to apply for a loan.

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Loans

Have you saved regularly for at least 16 weeks?

Less than £10 per week

£10 - £25 per week

More than £25 per week

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Loan Details:

Amount of loan ( in £, £7500 Maximum ) :

Repayment period (months)

Loan Calculator

Purpose of loan:

Loan Repayment Method - I will repay the loan by means of: *

Child Benefit Deduction

Standing Order

Other Benefit Deduction

Other

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About You:

Are you: *

Married

Single

Divorced/Separated

Living with Partner

Widowed

No of dependent children:

Do you: *

Own your own home

Rent your home

Live with parents

Other

Your ethnicity: *

White British

Other (Please State)

Your employment: *

Full Time

Part Time

Unemployed/Benefits

Retired

Homemaker

Existing loans and Finance

Value of existing loans, catalogues etc

Bank Loan/Overdraft

Payday loans, e.g. Wonga

Home finance e.g. Brighthouse, Perfect Home, Buy as you View, etc

Door step lenders e.g. Provident, Shopacheck, KDS, etc

Social Fund loans

Family or Friends

Goods from Catalogues

Other (Please give details)

Do you have any county court judgements? *

Yes

Have you been declared bankrupt or taken out a debt relief order? *

Yes

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Household Income:

Your Wage:

Partners Wage:

Child Benefits:

JSA:

Income Support:

DLA/PIP:

ESA/EESA:

Tax Credits:

Pension/Pension Credit:

Carer's Allowance:

Other Benefit:

Maintenance:

Other Income:

Total Income:

Weekly
(Min £100 per person per week)*

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Household Expenditure:

Food & non alcoholic drinks:

Alcoholic drinks & tobacco, etc:

Clothing & Footwear:

Housing costs (Inc. rent & council tax):

Water, Gas & Electric:

House Insurance & Appliance costs:

Health costs - Medicines:

Transport costs (bus fares/petrol/taxis):

Car Insurance / Car Tax:

TV Licence:

Pet costs & vet bills:

Childcare costs inc. pocket money:

Eating out:

Hairdresser & beauty products:

Lottery tickets / Gambling:

Internet & TV packages :

Phones - landlines & mobiles:

Debt repayments:

Other expenditure:

Total expenditure:

Weekly

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Additional Contact (in case of emergency)

Please give details of a relative not living at the same address

Name:

Title

First

Last

Address:

Postcode:

Telephone:

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Declaration:

I have given due consideration to all my other financial commitments and feel confident that I shall be able to make repayment in accordance with credit union rules. I understand that the information given on this form is for the purpose of obtaining a loan. To the best of my knowledge and belief all the statements are true.

Please note: All information provided is taken into consideration when deciding on a loan. No one piece of information is used alone.

Credit decisions and also the prevention of fraud and money laundering:

We may use credit reference and fraud prevention agencies to help us make decisions. A short guide to what we do and how both we and credit reference and fraud prevention agencies will use your information is detailed in the leaflet called:

A condensed guide to the use of your personal information by ourselves and at Credit Reference and Fraud Prevention Agencies. If you would like to read the full details of how your data may be used please visit our website at www.lasercu.org.uk or phone 01709 836500 or ask one of our staff.

By confirming your agreement to proceed you are accepting that we may each use your information in this way. LASER may liaise with your landlord and/or the local council to ensure that borrowers are financially able to meet their repayments.

I Agree

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Money Manager:

Income

Source

Description

Reference

Frequency

Next Due: (dd/mm/yyyy)

Amount

Bills

Please include up to 5 regular bills

Bill 1

Utility

Payee

Reference

Frequency

Next Due: (dd/mm/yyyy)

Amount

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CredECard Plus:

Your Visa credEcardplus will be issued by Contis Financial Services Ltd who is authorised by the Financial Services Authority to issue e-money (Firm Reference Number: 900025) and is a member of Visa.

Please note that credEcardplus prepaid card is an electronic money product and although it is a product regulated by the Financial Services Authority, it is not covered by the Financial Services Compensation Scheme. We ensure that any funds received by you are held in a segregated account so that in the unlikely event that Contis Financial Services Ltd becomes insolvent your funds will be protected against claims made by creditors.

By confirming your agreement to proceed you are accepting that we may each use your information in this way.

I Agree

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