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Loan Enquiry Form

Member Details

Employment Details

Spouse/Partners Details (where relevant)

Current Financial Situation

I declare that I am indebted to the following:

Original Amount

Balance Outstanding

Monthly Repayment Amount

Bank/Building Society


Credit Card


Previous Credit Union Loans



Repayment Amounts

Repayment Frequency




Loan Details


I declare that I am not indebted to any other Credit Union, Bank or Loan Agency either as a borrower or Guarantor, except as stated on this application. The statements herein are made for the purposes of obtaining the loan and are true to the best of my knowledge and belief.

Where a loan is applied for in the sum of €2,000 or more, the credit union is obliged to make an enquiry of the Central Credit Register (CCR) in respect of the borrower. Where a loan is granted in the sum of €500 or more, the credit union is obliged to report both personal details and credit details of the borrower to the CCR. The credit union is also obliged to verify the identity of borrowers and guarantors before sending information to the Central Credit Register.