Online Credit Application Form

We are committed to ensuring that your information is secure. In order to prevent unauthorized access or disclosure, we have put in place suitable physical, electronic and managerial procedures to safeguard and secure the information we collect online.

Applicant Information

Full Name
Date of Birth
Social Security Number
Address
City
State
Zip Code
Occupancy Duration

Previous Address (If less than 2 Years at Current Address)
Address
City
State
Zip Code

Address of work site (if different from physical or mailing address)
Address
City
State
Zip Code

Best Contact Number

Employment Information

Employer
Employer City/State
Position
Length of Employment
Previous Employer (if less than 2 years with present employer)
Annual Gross Income $ (Pre-tax Income)
Monthly Gross Income $ (Pre-tax Income)
Additional Monthly Income $ (Social Security, Child Support, Alimony, Rental Income, etc.)
Additional Income Source
Dependent Care Paid per Month

Mortgage/Property Information

Purchase Date
Purchase Price
Balance Owed
Value
Payment

Co-applicant Information (for joint accounts only)


Electronic Signature

I hereby authorize Northern Pacific exteriors, or Salal Credit Union, to verify my credit history and employment information provided on this form. By checking the box below and entering my name, I am electronically signing this form upon submission.


Signature of Applicant Date
Signature of Co-applicant Date