Loan and Credit Application

Space Coast Credit Union Online Loan and Credit Application

Space Coast Credit Union membership is open to all who work or live in Brevard, Broward, Flagler, Indian River, Martin, Miami-Dade, Monroe, Orange, Osceola, Palm Beach, Seminole, St. Johns, St. Lucie, or Volusia Counties in Florida.

You may utilize this application if you meet the membership area requirements.

Loan Information Loan Type I have read and agree to the Platinum Credit Card Terms and Conditions. Please specify other loan type Loan Term Amount Requested Purpose for this Loan Payment Method Payment Option

Other fees may apply depending on the loan you are requesting.

Personal Information First Name Middle Initial Last Name Date of Birth Social Security Number Please select an application type.

Joint Applicant Personal Information

First Name Middle Initial Last Name Date of Birth Social Security Number

Contact Information Email Address Telephone Number Street Address, Apartment/Unit# City Zip Code How Long at this address? Years Months Residence type Amount of Monthly Rent

Joint Applicant Information

Joint applicant's address is the same address as above

Street Address, Apartment/Unit# City Zip Code

How long at this address?

Years Months Residence type Monthly Rent

Telephone Number

Income Employment Status Employer Work Phone Date of Hire Position Gross Monthly Salary Other Income (Excluding Spouse's Income) Source of Other Income Do you receive alimony?* What is the monthly amount of the alimony received?*

Joint Applicant's Income Information

Employment Status Employer Work Phone Date of Hire Position Gross Monthly Salary Other Income (Excluding Spouse's Income) Source Does your spouse receive alimony? What is the monthly amount of the alimony received by your spouse?*

* Alimony, child support, or separate maintenance income need not be revealed if you do not wish to have it considered as a basis for repaying this obligation.

Agreement

AS A CONDITION OF CREDIT UNION OPENING MY ACCOUNT, I HEREBY GRANT TO CREDIT UNION A SECURITY INTEREST IN ALL SHARES, DEPOSITS AND OTHER FUNDS ON DEPOSIT WITH THE CREDIT UNION IN WHICH I HAVE AN OWNERSHIP INTEREST (other than an IRA account or an account where this security interest would cause the loss of tax-exempt or tax-deferred status). THE SECURITY INTEREST IS FOR ALL AMOUNTS OWED TO CREDIT UNION UNDER THE TERMS OF THIS AGREEMENT. IF I AM IN DEFAULT UNDER ANY TERM OF THIS AGREEMENT, CREDIT UNION SHALL HAVE A RIGHT TO IMMEDIATELY SEIZE MY SHARES, DEPOSITS AND/OR OTHER FUNDS WITH OUT NOTICE OR DEMAND TO ME AND TO APPLY SUCH FUNDS TO THE AMOUNTS OWED TO CREDIT UNION.

Please type the current year.

All fields marked in yellow are required.

Corporate Headquarters:

Space Coast Credit Union
8045 N. Wickham Road
Melbourne, Florida 32941

Space Coast Credit Union is federally insured by National Credit Union Administration.

Space Coast Credit Union Routing Number: 263177903
Deposit/Withdrawal Slips

Brevard: 321-752-2222
Broward: 954-704-5000
Miami-Dade: 305-882-5000
All Other Areas: 800-447-7228