Loan Application Start your loan application You MUST be a member of Celtic Credit Union to complete this application. If you've not yet joined Celtic Credit Union, please start by completing a membership form. Step 1 of 5 - Your Loan 0% Before you complete the Online Loan Application Form, please read the following information: Please ensure that you are a member of Celtic Credit Union before you apply, and are eligible to apply for a loan with us. Leave a minimum balance in your Share 1 savings account of £26 if you are applying for total borrowing under £2000. This will be used to cover a contribution and savings commitment. If your total borrowing exceeds £2000 then a minimum balance of £40 is required in your Share 1 account, this will be used to cover a contribution and credit check. Depending on your reason for the loan application, you may also need to provide proof of purpose. Provide bank statements for the last 3 months and supporting documentation for proof of income (payslips, benefit letter etc.) Please provide payslips relevant in the last 3 months (if applicable) as proof of income with the loan application. All loan applications are subject to a £5 Credit Check I understand that Celtic Credit Union will process my data in accordance with my rights under the Data Protection Act 1998 and GDPR 2018.Can CCU print of your Vox Account statements?* Yes, I give my permission No, I do not give my permission If you have a Vox Debit Card, Celtic Credit Union requires your statements for the last three months to go alongside your loan application. We can print these on your behalf but we require your permission to do so.Do you agree to this disclaimer?* Yes, I agree Section BreakHow much would you like to borrow?*Please enter the amount of the loan you require in £How would you like to pay back the loan?*Please selectCashStanding OrderPayrollBenefitPlease add the type of repayment method you would like to useHow often would you prefer to Pay?*Please selectEvery WeekEvery FortnightEvery MonthPlease add a preferred time of payments per monthWhat is the purpose of the loan?Example - Home Improvements, holiday etcHow long would you like this loan for?*Please Select6 Months1 Year2 Years3 Years4 Years5 YearsPlease select how long you would like the loan overDo you wish to clear your existing loan(s)?NoYes - One LoanYes - Both LoansHow much do you pledge to save?The pledge to save funds are only available from the 1st week of November to the end of December each year.How often would you like to save? per week per fortnight per month Section BreakIf your loan is approved, how would you want this paid to you?*Please SelectBACSChequeCredit Union AccountPlease add how you would like us to pay you the loan, if this is into your bank account you will need to add the relevant information. ie Sort Code, Account Number etcAccount NameSort CodeAccount NumberCheque Payable ToPlease add the name that of the person that the cheque is payable to.Membership Number*Please enter your Credit Union account detailsMembership Name* Section BreakTitlePlease ChooseMrMrsMissDrMasterMsRevPlease enter your title, eg Mr, MrsFirst Name*Please enter your first nameMiddle NameIf you have a middle name please enter it hereSurname*Please enter your last name hereDate of Birth Date Format: DD slash MM slash YYYY Please enter your date of birth - Day,Month,YearPrefered Contact* Email Telephone Mobile Please select your preferred contact method.Email Address Please enter a valid email address, if you do not have one please enter [email protected]Home TelephonePlease enter your full telephone number with area codeMobile Telephone NumberIf you do not own a mobile phone please enter 000Membership NumberThis is your Credit Union Membership numberNI Number*This will be on your payslip, P45 or tax officeSection BreakHousehold Status*Please SelectOwner OccupiedPrivately RentedLocal Authority / Housing AssociationFamily / FriendsNFAOtherPlease state whether your property is owned or rented? If your property is rented please state your landlord.LandlordYour Address* Street Address Address Line 2 City County / State / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Please add where you are living at present, if you have been at the address for less than 6 months please complete the other sections.Number of Dependants*This includes anyone living on the household incomeHow long have you lived at this address*Please ChooseMore than 6 MonthsLess than 6 MonthsPrevious Address Street Address Address Line 2 City County / State / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Employment Status*UnemployedEmployed Full TimeEmployed Part TimeSelf EmployedStudentRetiredOtherPlease add all employment information, if applicable.Occupation*Employers NameEmployers Address Street Address Address Line 2 City County / State / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Time in EmploymentPlease add the duration in yearsIncome from your employmentWhen do you receive your wages per week per fortnight per month Section BreakPlease state what type of benefits you receive. Please add your monthly benefits in pounds(£), if you do not receive benefits for all section please leave them blank. Note - (If you receive weekly benefits then multiply the amount by 4 to get a monthly figure, if you receive fortnighly benefits then multiply the amount by 2) If you are in receipt of Universal Credit, you will need to provide your Universal Credit Breakdown that explains which benefits are included in your payment, failure to provide this information may result in your application being delayed.Carers AllowanceChild BenefitChild Tax CreditsCouncil Tax BenefitDisability Living Allowance excluding Mobility ElementDisability Living Allowance including Mobility ElementEmployment Support Allowance (ESA)Housing BenefitIncome SupportJob Seekers AllowancePension CreditWorking Tax CreditUniversal CreditTotal Monthly Income from BenefitsPlease ensure that your entries are per month and are the correct amount before continuing.Section BreakSend us proof of your Income To ensure that your loan application is prompt please scan and send us any relevant information, ie Payslip, Bank Statement, etc.Would you like to send us your documents? Yes No This may speed up your loan application, we allow jpg, png or pdf documents. If you choose 'Yes' Please upload 1 or 2 documents.Document 1Accepted file types: jpg, png, pdf, doc, docx, gif.Scan and upload your files here, this may speed up your loan application, we only allow jpg, png or pdf documents.Document 2Accepted file types: jpg, png, pdf, doc, docx, gif.Scan and upload your files here, this may speed up your loan application, we only allow jpg, png or pdf documents.Document 3Accepted file types: jpg, png, pdf, doc, docx, gif.Scan and upload your files here, this may speed up your loan application, we only allow jpg, png or pdf documents. You MUST complete as much accurate information as possible, making sure to enter information for EVERYTHING you pay for during the month.RentMortgageCouncil TaxWater RatesUtility Bills (Gas, Electricity etc.)TV LicenseGroceriesCleaning Products / ToiletriesBroadbandMobile Phone 1Mobile Phone 2TV Fees (Sky, Virgin, BT etc.)Fuel Costs (Petrol / Diesel)Car MaintenanceCar InsuranceTravel Costs (Bus Fares etc.)Home InsuranceLife InsuranceSavings / PensionsChild Care/Maintenance FeesFinesCharitable DonationsClub / Membership FeesClothingSocialTobaccoRecreational ActivitiesSchool DinnersOtherPlease add all other expenditures you have.Total Monthly ExpenditurePlease ensure that your entries are per month and are the correct amount before continuing.Section BreakCredit Agreement(s) Expenditure This section applies to any outstanding borrowing that you are repaying every month. False or misleading information provided here, has the potential for your application to be delayed or outright refused. Please take care to make sure ALL necessary sections are completed.Loan/Lending AgreementsBank Personal LoanBalance of Bank Personal Loan left to repayPerfect HomeBalance of Perfect Home Loan left to repayValley FinanceBalance of Valley Finance Loan left to repayFamily FinanceBalance of Family Finance Loan left to repayLoans @ HomeBalance of Loans @ Home debt left to repayBrighthouseBalance of Brighthouse debt left to repayCredit Union LoansBalance of Credit Union Loans left to repayMoney ShopBalance of Money Shop Loan left to repayJ R NaylorBalance of J R Naylor finance left to repayOther LendersBalance of loan from other lender left to repayOther Lenders 2Balance of loan from other lender left to repayDebt RecoveryHigh Court EnforcementTotal of High Court Enforcement debt left to payAndrew JamesTotal of Andrew James debt left to payMoorcroftTotal of Moorcroft debt left to payCabotTotal of Cabot debt left to payOrbitTotal of Orbit debt left to payLowellTotal of Lowell debt left to payAllied InternationalTotal of Allied International debt left to payOther Debt CollectorsTotal of debt to other debt collectors left to payOther CreditorsOutstanding debt to other creditor left to payOther Creditors 2Outstanding debt to other creditor left to payTotal Monthly Credit ExpenditurePlease ensure that your entries are per month and are the correct amount before continuing.Grand Total Monthly ExpenditureThis is your grand total of expenditure each month. Previous Credit HistoryHave you missed/been late with any repayments in the last 6 months?* Yes No Do you have any CCJ's, Charging Orders or Default Notices registered against you?* Yes No Are you currently under a debt management plan?* Yes No Are you in the process of taking any money/debt relief orders including I.V.As?* Yes No Have you ever been declared bankrupt or the subject of an IVA?* Yes No Do you have any attachment of earnings against you?* Yes No Have you got / applied for a Social Fund Loan?* Yes No If you have answered yes to any of the above, please provide further information below (please provide all relevant documentation as evidence)Section BreakAdditional InformationPlease enter additional information that will support your loan application. If you do not wish to state anything then please enter N/ASection BreakDeclaration: I declare that I have read and understood the information in the loan application - guidance notes and on this form. I also declare that the information that I have given on this form, to the best of my knowledge and belief, is accurate and complete and i agree to notify the credit union if any of the information changes before my loan is assessed. I do not have reason to believe that my personal or financial circumstances will change during the loan term. I understand I have a responsibility to make all my loan payments on time and in full, and i promise to do so. I understand that the provision of false information is fraud and that the Credit Union may take appropriate action if I am found to have deliberately provided false or misleading information. I understand that my application is subject to approval. Credit Referencing & Fraud Prevention Agencies Declaration We may make searches about you at credit reference agencies who will supply us with credit information as well as information from the Electoral Register. The agencies will record details of any search whether or not this application progresses. Credit searches and other information, which is provided to us and/or the credit reference agencies about you and anyone with whom you are linked financially, may be used by us in our credit decisions. Data Protection Statement In accordance with the principles of the Data Protection Act 1998 and GDPR May 2018, we will use your personal details for the purpose of managing your accounts with Celtic Credit Union. Your personal details will be treated confidentially and will only be shared with other agencies for the purposes of credit referencing and debt recovery, for which purposes we hold a Consumer Credit License.I declare to the best of my knowledge and belief that*I declare to the best of my knowledge and belief thatPlease ChooseI am in good healthI am not in good healthand I am*I declare to the best of my knowledge and belief thatPlease ChooseFit to follow my normal occupationnot fit to follow my normal occupationI have read the terms and conditions* Yes I have read these