Do you wish to have Debt Protection on this loan?

Credit Life Protection

Credit Disability Protection

Unemployment Protection

Upload the most recent copy of your paystub *

Co-Applicant: Upload the most recent copy of your paystub *

Other documents we may need to process your application:

Loan to purchase a vehicle or RV:

Income Verification (2 most recent paystubs)
Proof of Insurance
Bill of Sale

Unsecured Loan:

Income Verification (2 most recent paystubs)

Loan Information

Frick Financial Federal Credit Union Loan Application

App Type App Type Folder

Single Application

Joint Application

Account Number

Amount Requested

Loan Type

VIN #

Make

Model

Year

Mileage

Collateral

Purpose

Repayment Method

Loan Term (in months)

Do you want Credit Disability Insurance in connection with this loan?

Yes, I want Credit Disability Insurance

No, I do not want Credit Disability Insurance

Do you want Credit Life Insurance in connection with this loan?

Yes, I want Credit Life Insurance

No, I do not want Credit Life Insurance

Primary Applicant

Primary Applicant - Personal information

First Name

Middle Initial

Last Name

Social Security No.

Driver's License No.

Driver's License State

Date of Birth

Address

Address 2

City

State

Zip Code

Years There

Previous Address (if less than 2 years at present address)

Address 2

City

State

Zip Code

Years There

Phone (Best contact phone #)

No. of Dependents

Complete for joint credit, secured credit, or if you live in a community property state

Married

Separated

Unmarried (single / divorced / widowed)

Employment information

Current Employer

Position

Annual Income

Employee Start Date

Previous employer (if less than 2 years at present employer)

Start date

Other Income

Source

Credit information

Residence

I own my residence

I rent my residence

I live with relatives

Present Mortgage Co., Landlord, or Relative

Monthly Mortgage/Rent Payment (includes taxes and insurance)

Current Value. If you own your home, what is the current value?

Mortgage Balance

Is the property described your principal dwelling?

Yes, the property is my principal dwelling

No, the property is not my principal dwelling

Any proceeds for a Refinanced Mortgage, Home Equity, or Home Improvement?

Yes, there are proceeds

No, there are not proceeds

Is the property described listed as the applicant's address in the "Personal Information" section?

Yes, the addresses are the same

No, the addresses are different

Other liens

Is anyone other than your spouse a part owner of your home?

Yes, there is another owner of my home

No, there is not another owner of my home

Have you ever had a car or other personal property repossessed by a dealer or finance company, filed for bankruptcy, or been a party to a wage assignment or collection suit, or have you ever been declined on a loan application with this credit union?

Yes

Reference

Name of nearest relative not living with you

Relatives Address

Address 2

City

State

Zip Code

Relationship

Phone

Additional Questions

Are you a US citizen or permanent resident alien?

Yes, I am a US Citizen or permanent resident alien

No, I am not a US Citizen or permanent resident alien

Do you have any outstanding judgments?

Yes, I have outstanding judgments

No, I do not have outstanding judgments

Is your income likely to decline in the next two years?

Yes, my income is likely to decline

No, my income is not likely to decline

Are you a co-maker, co-signer, or guarantor on any loan not listed?

Yes, I am a co-maker

No, I am not a co-maker

Are you a student or do you have a work visa?

Yes, I am a student or have a work visa

No, I am not a student or have a work visa

Have you filed for bankruptcy or had a debt adjustment plan confirmed under chapter 13?

Yes, I have filed for bankruptcy or debt adjustment

No, I have not filed for bankruptcy or debt adjustment

Have you had property foreclosed upon or given a deed in lieu of foreclosure in the last 7 years?

Yes, I have had property foreclosed

No, I have not had property foreclosed

Are you a party in a lawsuit?

Yes, I am a party in a lawsuit

No, I am not a party in a lawsuit

For whom?

To whom?

Home equity information

Share draft or checking amount

Name of depository

Address of depository

Savings amount

Name of depository

Address of depository

Joint Applicant

Joint Applicant - Personal information

First Name

Middle Initial

Last Name

Social Security No.

Driver's License No.

Driver's License State

Date of Birth

Address

Address 2

City

State

Zip Code

Years There

Previous Address (if less than 2 years at present address)

Address 2

City

State

Zip Code

Years There

Phone (Best contact phone #)

No. of Dependents

Complete for joint credit, secured credit, or if you live in a community property state

Married

Separated

Unmarried (single / divorced / widowed)

Employment information

Current Employer

Position

Annual Income

Employee Start Date

Previous employer (if less than 2 years at present employer)

Start date

Other Income

Source

Credit information

Residence

I own my residence

I rent my residence

I live with relatives

Present Mortgage Co., Landlord, or Relative

Monthly Mortgage/Rent Payment (includes taxes and insurance)

Current Value * If you own your home, what is the current value?

Mortgage Balance

Is the property described your principal dwelling?

Yes, the property is my principal dwelling

No, the property is not my principal dwelling

Any proceeds for a Refinanced Mortgage, Home Equity, or Home Improvement?

Yes, there are proceeds

No, there are not proceeds

Is the property described listed as the applicant's address in the "Personal Information" section?

Yes, the addresses are the same

No, the addresses are different

Other liens

Is anyone other than your spouse a part owner of your home?

Yes, there is another owner of my home

No, there is not another owner of my home

Yes

Reference

Name of nearest relative not living with you

Relatives Address

Address 2

City

State

Zip Code

Relationship

Phone

Additional Questions

Are you a US citizen or permanent resident alien?

Yes, I am a US Citizen or permanent resident alien

No, I am not a US Citizen or permanent resident alien

Do you have any outstanding judgments?

Yes, I have outstanding judgments

No, I do not have outstanding judgments

Is your income likely to decline in the next two years?

Yes, my income is likely to decline

No, my income is not likely to decline

Are you a co-maker, co-signer, or guarantor on any loan not listed?

Yes, I am a co-maker

No, I am not a co-maker

Are you a student or do you have a work visa?

Yes, I am a student or have a work visa

No, I am not a student or have a work visa

Have you filed for bankruptcy or had a debt adjustment plan confirmed under chapter 13?

Yes, I have filed for bankruptcy or debt adjustment

No, I have not filed for bankruptcy or debt adjustment

Have you had property foreclosed upon or given a deed in lieu of foreclosure in the last 7 years?

Yes, I have had property foreclosed

No, I have not had property foreclosed

Are you a party in a lawsuit?

Yes, I am a party in a lawsuit

No, I am not a party in a lawsuit

Terms and Conditions

Assets and Debts

List your assets.

Asset 1

Asset 1 location

Asset 1 market value

Pledged as collateral for another loan?

Yes, this asset is pledged as collateral

No, this asset is not pledged as collateral

Owner of asset

Primary Applicant is the owner of asset

Joint Applicant is the owner of asset

Asset 2

Asset 2 location

Asset 2 market value

Pledged as collateral for another loan?

Yes, this asset is pledged as collateral

No, this asset is not pledged as collateral

Owner of asset

Primary Applicant is the owner of asset

Joint Applicant is the owner of asset

Asset 3

Asset 3 location

Asset 3 market value

Pledged as collateral for another loan?

Yes, this asset is pledged as collateral

No, this asset is not pledged as collateral

Owner of asset

Primary Applicant is the owner of asset

Joint Applicant is the owner of asset

Asset 4

Asset 4 location

Asset 4 market value

Pledged as collateral for another loan?

Yes, this asset is pledged as collateral

No, this asset is not pledged as collateral

Owner of asset

Primary Applicant is the owner of asset

Joint Applicant is the owner of asset

List your debts.

Debt 1

Debt 1 creditor

Debt 1 original balance

Debt 1 present balance

Debt 1 monthly payment

Debt 1 Owner:

Primary Applicant is the owner of debt

Joint Applicant is the owner of debt

Debt 2

Debt 2 creditor

Debt 2 original balance

Debt 2 present balance

Debt 2 monthly payment

Debt 2 Owner:

Primary Applicant is the owner of debt

Joint Applicant is the owner of debt

Debt 3

Debt 3 creditor

Debt 3 original balance

Debt 3 present balance

Debt 3 monthly payment

Debt 3 Owner:

Primary Applicant is the owner of debt

Joint Applicant is the owner of debt

Debt 4

Debt 4 creditor

Debt 4 original balance

Debt 4 present balance

Debt 4 monthly payment

Debt 4 Owner:

Primary Applicant is the owner of debt

Joint Applicant is the owner of debt

Debt 5

Debt 5 creditor

Debt 5 original balance

Debt 5 present balance

Debt 5 monthly payment

Debt 5 Owner:

Primary Applicant is the owner of debt

Joint Applicant is the owner of debt

Debt 6

Debt 6 creditor

Debt 6 original balance

Debt 6 present balance

Debt 6 monthly payment

Debt 6 Owner:

Primary Applicant is the owner of debt

Joint Applicant is the owner of debt

Terms and Conditions

Do you agree with the above terms and conditions?

Yes, I agree to the terms

No, I do not agree to the terms

Signature (type your full name)

Date

Co-Applicant

Do you agree with the above terms and conditions?

Yes, I agree to the terms

No, I do not agree to the terms

Signature (type your full name)

Date

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(724) 438-5123

(724) 438-7491

Routing Number: 243385155

info@frickfin.org

235 Pittsburgh Street
Uniontown, PA 15401

Hours of Operation

Hours for All Offices:
Mon – Thu: 9 am to 4:30 pm

Friday – 9 am to 5 pm

Helpful Links

Membership Account Agreement

For After Hours

After Hours Visa Credit Card: 1-800-991-4961

After Hours Visa Debit Card: 1-800-523-4175

PIN Now: 1-866-985-2273

Frick Financial Federal Credit Union

2026

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