Loan and Credit Application
Space Coast Credit Union membership open to all who work or live in Brevard, Volusia, Flagler, Indian River, Osceola, Orange, Seminole, or St. Lucie Counties in Florida. You may utilize this application if you meet the membership area requirements.
Step 1. Loan Information 
I am applying as 
Loan Type 
If other, specify
Loan Term 
Amount Requested 
Purpose 
If purchasing a car, will you be trading in current car?
Financed by 
If refinancing, name of current finance company 
Payment Method 
Payment Option 
Payment Protection Coverage (optional) 
1. The borrower understands that he or she has the option of assigning any other policy or policies the borrower owns or may procure for the purpose of covering such loan and that the policy need not be purchased from the creditor agent in order to obtain the loan.
2. The borrower understands that the credit life coverage may be deferred if, at the time of application, the borrower is unable to engage in employment or unable to perform normal activities of a person like age, sex, if the proposed credit life insurance policy contains this restriction.
3. The borrower understands that the benefits under the policy will terminate when the borrower reaches a certain age and that the borrower's age is accurately represented on the application or policy.
Other fees may apply depending on the loan you are requesting. 
Step 2. Personal Information 
First Name, MI, Last Name 
Primary Applicant SCCU Account Number 
(non-members leave blank) 
Primary Applicant e-mail address 
Social Security # 
Date of Birth  
Street address, Apt/Unit# 
City 
Zipcode 
How Long at this address?  Years Months  
Own/Buying RentLeasingLive w/relativesOther 
Amount of Monthly Rent 
Do you have a first mortgage? 
Original Amount 
Current Balance 
Monthly Payment 
Do you have a second mortgage? 
Original Amount 
Current Balance 
Monthly Payment 
Current Market Value 
Purchase Price 
Home Phone 
Cell Phone 
Marital Status 
Step 3. Income 
Employment Status 
Employer 
Work Phone 
Date of Hire 
Position 
Gross Monthly Salary 
Other Income (Excluding Spouse's Income) 
Source 
Do you or your spouse receive alimony?*
If so, what is the monthly amount?* 
* 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.
Step 4. Spouse or Co-Applicant Information 
First Name, MI, Last Name 
Social Security # 
Date of Birth  
Click here if same address as above 
Street Address, Apt/Unit# 
City, State, Zip 
How long at this address?  Years Months 
Own/Buying RentLeasingLive w/relativesOther 
Monthly Rent (if not living with spouse) 
Home Phone 
Marital Status 
Step 5. Spouse or Co-Applicant Income 
Employment Status 
Employer 
Work Phone 
Date of Hire 
Position 
Gross Monthly Salary 
Other Income (Excluding Spouse's Income) 
Source 
Do you or your spouse receive alimony? 
If so, what is the monthly amount? 
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.