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Open End Lending Plan Advance Request

Important Instructions:
Complete this form if you have already borrowed from Qside in the past and want to apply for another loan (this is called an “advance”). If you have never borrowed from Qside before and want to apply for a loan, you must complete the “Initial Loan Application".

Complete the “Primary Borrower” portion if you are requesting the advance in your name only. If you are requesting the advance with a joint borrower, you must complete the “Primary Borrower” portion and the joint borrower must complete the “Joint Borrower” portion. Both the Primary Borrower and Joint Borrower must be members of Qside Federal Credit Union, and both assume responsibility for any charges made to the account. Availability of an individual account with an authorized user depends on the board policy.

Advance Information:

Type of advance requested *:
Advance amount requested *:
Are you requesting a pre-approval or an actual advance?*:
Is this advance request for refinancing an existing loan?:
Advance Purpose*:
Is there a Joint Borrower for this advance request?*
Promo Code:
How did you hear about Qside's advance products? *:

Primary Borrower

First Name*: Last Name*:
Member Number*: Social Security Number*:
Date of Birth*:    
Home Phone*:
Work Phone:
Cell Phone:
Email Address*:
Home Address*:
State*: Zip*:
Living Situation*:
  Mortgage or Rent Payment*
  Number of years residing there*
Name of Nearest Living Relative:*
Address of Nearest Living Relative:*
Phone Number:*
State:* Zip:*

Employment Information

RETIREES: If you are retired, please enter "Retired" in all the fields below.

Employer's Phone Number*:
Employer's Address*
State:* Zip:*
Start Date*: Gross Income*:
Department*: Job Title*:
Supervisor's Name*: Supervisor's Telephone*:

Additional Required Information
For Equi-Fixsm Home Equity Loan and Equi-Flexsm Home Equity Line of Credit applications. 

Property Address:
Estimated Value: $
Property Type:
Annual Property Taxes: $
Annual Property Taxes: $
Annual Hazard Insurance Premium: $ /year
Annual Flood Insurance Premium: $ /year
Monthly Common Charge:
(For Condominiums)
$ /month
Monthly Homeowner Association Fee:
(If Applicable)
$ /month
Property is my Primary Residence:
#/Units that are Owner Occupied:
#/Units that are Rented:



Joint Borrower
If there is a joint borrower, ALL of the following information must be entered in order for your advance request to process.

First Name: Last Name:
Member Number: Social Security Number:
Date of Birth:
Home Phone:
Email Address:
Home Adress:
State: Zip:

Joint Borrower Employment Information

Employer's Phone Number:
Start Date: Gross Yearly Income:
Department: Job Title


Income verification is required.  Alimony, child support, or separate maintenance income need not be listed unless you choose to have such income considered regarding extension and repayment of the credit requested.

We will begin processing this request immediately after receiving it.  A loan officer may contact you for further information in order to process your advance request and a form requesting your signature will be forwarded to you soon to complete the advance request process.

You authorize Qside Federal Credit Union to obtain credit reports in connection with this application for credit and for any update, increase, renewal, extension or collection of the credit received.  You understand that Qside Federal Credit Union will rely on the information in this application and your credit report to make its decision.  If you request, Qside Federal Credit Union will tell you the name and address of any credit bureau from which it received a credit report on you.

I certify that statements on this advance request are true and complete. I authorize any person, association, firm or corporation to furnish, on request of this Credit Union, information concerning me or my affairs.  I understand that under 18 U.S.C. § 1014, it is a federal crime to knowingly make a false statement on the application of a Federal Credit Union.

Enter the code shown above:

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All rights reserved.