Financial Counseling & Credit Report Authorization

Financial Counseling Authorization

1. I understand that ANECA Credit Union will provide a confidential budgeting session and financial counseling to help me balance my monthly income and expenses. A portion of this session will focus on reviewing a reasonable means of repaying my creditors. I understand this service is voluntary and free of charge.

2. I authorize the Credit Union to check my credit report and score.

3. ANECA Credit Union staff and Financial Counselors will not provide legal advice. I understand that I will make my own financial decisions and ANECA Credit Union does not warrant, represent, or require me to take any specific action.

4. I hold ANECA Credit Union, its staff, employees, Financial Counselors, agents, and volunteers harmless from any claim, suit, action, or demand of my creditors, myself, or any other person resulting from me taking any action, my failure to take an action, and any decisions made after advice or counseling.

5. I understand that ANECA Credit Union also provides budgeting and credit related educational seminars which I can attend free of charge to support my overall financial goals.

6. I understand and accept ANECA Credit Union’s Financial Counseling program is designed to help members learn to budget, save, repay debt and build credit.

Member Agreement *

By checking this box and entering your full name below your are agreeing to the terms and conditions stated above.

Full Name *

FOR CREDIT UNION USE ONLY

Counselor Name

Date

Credit Report Authorization

This authorization is valid for purposes of verifying information given pursuant to employment, leasing, rental, business negotiations, or any other lawful purpose covered under the Fair Credit Reporting Act (FCRA).

This authorization also includes all corporation, former employers, credit agencies, educational institutions, law enforcement agencies, city, state, county and federal courts and agencies, military services and persons to release all information they may have about me including criminal and driving history. This authorization shall be valid in original or copy form.

Applicant's Name *

Social Security Number *

Date of Birth *

Driver's License Number *

Email

Phone Number #1

Phone Number #2

Credit Report Authorization - continued

*If you are living in Temporary Housing, such as a shelter or group home, please enter the address on your ID as your current address.

Current Street Address *

City *

ZIP Code *

Move In Date *

*If you have not lived at your current address for at least 2 years, please fill out the Prior Address information below.

Prior Street Address

City

ZIP Code

Move In Date

Credit Report Authorization - continued

Optional information that can help us know if you are prequalified for offers to help you meet your financial goals.

Annual Income $ *

Employment Status:

Full Time

Part Time

Retired

Other (please describe these details below)

Other employment details

Future credit / lending needs:

Auto

Home

Debt Consolidation

Other (please describe these details below)

Other credit / lending needs

Please upload an image of your valid Driver's License or State Issued ID below.Label

Available image types: .png, .jpg, .jpeg. *

Click or drag & drop image here to upload

By checking this box, I authorize a Consumer Credit Report be obtained.

Thank You