Loan Application Form

Step 1 of 4 - Loan Details

Amount Required €*
Loan Purpose
Intended Use of Loan*
Loan Term Required*
Loan Term Required*
Loan Term Required*
If Other - Please specify
Repayment Frequency*

Personal Details
Member Number (If Applicable)
First Name*
Surname*
Mobile Phone Number*
E-mail Address*
Please enter E-mail address and mobile phone number accurately as we will send you important information on submission of your application.
Date of Birth*
Current Address*
Street Address Town County Eircode Country
Residential Status*
Marital Status*
Current Employment Details
Employer Name*
Occupation
Time in Employment (Months/Years)
Employment Type
Net Income per week:
Any other income source:
State type of other income:

Spouse/Partners Details (where relevant)
Spouse/Partner Occupation:
Spouse/Partner Net Income per week:
Number Of Dependants*
Dependants Age Range (If applicable)

Financial Details
Mortgage 1
Mortgage 2
Monthly Repayment
Monthly Repayment
Amount Outstanding
Amount Outstanding
Lender
Lender
Personal Loan
Credit Card 1
Monthly Repayment
Monthly Repayment
Amount Outstanding
Amount Outstanding
Lender
Lender
Credit Card 2
Other Loans
Monthly Repayment
Monthly Repayment
Amount Outstanding
Amount Outstanding
Lender
Lender
Other Financial Commitments
Eg. Maintenance or Childcare Costs
Monthly Repayment
Are you a guarantor for any loan?
Financial Institution:
Amount of Loan:
Monthly Repayment:
How did you hear about our loan products?
Other
Marketing Consent
I consent to the Credit Union, or third parties selected by the Credit Union, informing me of goods or services that may be of interest to me by email, telephone call, text message or fax:
Email*
- Yes
- No
Telephone Call*
- Yes
- No
Text
- Yes
- No
Post
- Yes
- No
Irish Credit Bureau Consent
ICB are using Legitimate Interests (GDPR Article 6 (f)) as the legal basis for processing of your personal and credit information. These Legitimate Interests are promoting greater financial stability by supporting a full and accurate assessment of loan applications, aiding in the avoidance of over-indebtedness, assisting in lowering the cost of credit, complying with and supporting compliance with legal and regulatory requirements, enabling more consistent, faster decision-making in the provision of credit and assisting in fraud prevention. Please review ICB’s Fair Processing Notice which is available at http://www.icb.ie/pdf/Fair Processing Notice.pdf. It documents who they are, what they do, details of their Data Protection Officer, how they get the data, why they take it, what personal data they hold, what they do with it, how long they retain it, who they share it with, what entitles them to process the data (legitimate interests), what happens if your data is inaccurate and your rights i.e. right to information, right of access, right to complain, right to object, right to restrict, right to request erasure and right to request correction of your personal information.
Central Credit Register
Under the Credit Reporting Act 2013 lenders are required to provide personal and credit information for credit applications and credit agreements of €500 and above to the Central Credit Register. This information will be held on the Central Credit Register and may be used by other lenders when making decisions on your credit applications and credit agreements. The Central Credit Register is owned and operated by the Central Bank of Ireland. For more information see www.centralcreditregister.ie
Privacy Notice
The details provided in this application form together with any other information that is furnished to us in connection with this application will be retained and processed by Ballinasloe Credit Union in accordance with the Privacy Notice which is available on our website at www.ballinasloecreditunion.com and in any of our offices.
Declaration
I/We are not indebted to any other credit union, bank or loan agency either as borrower or guarantor, except as declared in this application (under the financial details headings). I/We declare that the information supplied by me/us regarding my income and expenses in support of my/our loan application is true and accurate. I/We confirm that I/We am/are fit to follow my/our normal occupation or duties.
Upload Relevant Documents
To support this application the following documents are required:
- Photo ID- Driving Licence or Passport
- Proof of Address – Utility bill/ Bank Statement etc (dated within the last 6 months)
- Two recent payslips (where applicable)
- Last 3 months current account bank statement (where applicable)
- Upload Files
  Drop files here or
- Print Name*
- Signature*

LOAN APPLICATION FORM

Step 1 of 4 - Loan Details

Loan Purpose

Personal Details

Current Employment Details

Spouse/Partners Details (where relevant)

Financial Details

Other Financial Commitments

Marketing Consent

Irish Credit Bureau Consent

Central Credit Register

Privacy Notice

Declaration

Upload Relevant Documents

Contact Info

Opening Hours

Regulatory Information

Regulatory Warnings