Consent* By sending this form I consent to sharing my contact details including my home address, phone number and email address with CUIS Financial Services DAC, t/a Peopl.
I agree*
I Would like to be contacted by phone This field is hidden when viewing the form
Unique ID (from Lead)
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Status
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Topic
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How much do you wish to borrow?
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Calculated Rate
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For how long? (in years)
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Your Monthly Loan Repayments Will Be:
Interest calculated at 8.95% variable rate (9.3% APR).
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fortnightly repayment
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weekly repayment
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Total Cost of Credit
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Contact Details This field is hidden when viewing the form
Name*
Mr. Mrs. Ms. Miss
Prefix
First
Last
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Email*
Please enter your personal email address.
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Phone*
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Applying for a loan requires processing of your personal data.* This field is hidden when viewing the form
Consent
Your enquiry has been submitted, we'll be in touch soon! Got 3 minutes to complete the full application?
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Application Details This field is hidden when viewing the form
Loan Application Amount
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Loan Purpose Personal Loan Motor Loan Home Improvement Loan Holiday Loan Home Loan Debt Consolidation Loan Secured Savings Loan Think Big Loan Other - please specify below
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Other loan purpose
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Term of Loan (in years)*
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Repayment Frequency Monthly Fortnightly Weekly
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Monthly Repayment
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fortnightly repayment
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weekly repayment
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Repayment Amount
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Personal Details This field is hidden when viewing the form
Please fill in your Date of Birth* This field is hidden when viewing the form
Do you know your membership number? This field is hidden when viewing the form
Please enter your membership number:
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Marital Status Single Married Divorced Separated Widowed Cohabiting Civil Partnership
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Do you know your PPS number?
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Please enter your home address
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Years living at home address* This field is hidden when viewing the form
Living Situation* This field is hidden when viewing the form
Your Employment Details This field is hidden when viewing the form
Employment Status Full Time Part Time Self Employed Retired Unemployed/ Receiving Disability Allowance Student
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Are you a public sector employee? This field is hidden when viewing the form
Employment Type Permanent Temporary Contract
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Employer Name*
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Employer Address*
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Time in current Employment (in years)*
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Your Income This field is hidden when viewing the form
Monthly Take Home Pay*
After Tax & Deductions
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Are you in receipt of social welfare payments?* This field is hidden when viewing the form
How often do you receive social welfare payments? Weekly Fortnightly Monthly
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How much do you receive for this social welfare payment?*
E.g. Child Benefit, Job Seeker's Allowance, Family Income Supplement etc.
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Are you in receipt of rental income? This field is hidden when viewing the form
Monthly Rental Income
If Applicable
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Do you have other monthly income? This field is hidden when viewing the form
What is the source of this income?
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Other Monthly Income
After Tax & Deductions
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Your Outgoings This field is hidden when viewing the form
Type of Monthly Expense Rent/Mortgage Credit Card Repayment Loan Repayment Other
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Amount
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Do you have an additional monthly expense? This field is hidden when viewing the form
Type of Monthly Expense Credit Card Repayment Rent/Mortgage Loan Repayment Other
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Amount
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Do you have a further monthly expense? This field is hidden when viewing the form
Type of Monthly Expense Loan Repayment Credit Card Repayment Rent/Mortgage Other
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Amount
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Do you have a further monthly expense? This field is hidden when viewing the form
Type of Monthly Expense Loan Repayment Credit Card Repayment Rent/Mortgage Other
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Amount
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Total Monthly Outgoings
Please consider any Mortgages, Loans, Credit Cards, Overdrafts etc.
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Authorisation and Application This field is hidden when viewing the form
Below is important information relating to your application. Please do not submit an application before reading all the information carefully.* I confirm, acknowledge and agree;
That this Application Web Form together with figures quoted in repayment calculators may not be construed as an offer of credit by or on behalf of the Credit Union.
That all statements, information and details given in this application and any documentation provided in support of it are true, accurate and complete and I understand they are subject to verification by the Credit Union.
That the Credit Union may contact my employer to verify my employment details and/or salary information for the purposes of underwriting this application.
That loan approval is subject to the Credit Union’s credit approval process and lending criteria and that the Credit Union reserves the right to restrict, amend, reduce or withdraw any loan offer made.
That the loan will be subject to the rates and interest of the Credit Union and I will pay all fees and charges in connection with the loan as set out in the Credit Agreement that will issue to me on the approval of my application.
That loan approval may be subject to conditions as specified in the Credit Agreement. This may include that my shares may be held as security against the loan.
That upon execution of the Credit Agreement by the Credit Union and I, we will both be bound by that Credit Agreement.
Loan Protection Insurance is cover Capital Credit Union provides for eligible members with credit union loans. The premium for this insurance is paid by the credit union. Cover is subject to terms and conditions, eligibility requirements and certain cover limits.
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Consent for Authorisation and Application* This field is hidden when viewing the form
Credit Checks
STATUTORY NOTICE – Central Credit Register (CCR):www.centralcreditregister.ie
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It is a necessary condition of a credit application that satisfactory credit checks and assessments be conducted by the Credit Union. These will include checks with the Central Credit Register and/or the Irish Credit Bureau DAC or other credit reference agencies.* This field is hidden when viewing the form
Receive Certain Notices Electronically This field is hidden when viewing the form
From time to time the credit union would like to send Notices to you electronically including notice of annual general meetings, special general meetings and our annual report. This field is hidden when viewing the form
Marketing Consent From time to time, the Credit Union may wish to inform you of goods, services, products, competitions, promotional offers and Credit Union news which may be of interest to you. The use of your details for these purposes will depend on the preferences that you express below. You can update your preferences at any time by contacting us by letter or phone. Please note, the Credit Union may still contact you where there is a legal or legitimate interest basis for that contact.
I Would like to be contacted by: This field is hidden when viewing the form
Email This field is hidden when viewing the form
Text Message This field is hidden when viewing the form
Phone This field is hidden when viewing the form
Post You can contact the Credit Union in the future if you change your mind and no longer wish to receive marketing communications. You can contact the Credit Union in the future if you change your mind and no longer wish to receive marketing communications.
Warning: If you do not meet the repayments on your credit agreement, your account will go into arrears. This may affect your credit rating, which may limit your ability to access credit in the future.
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credit union id
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Loan Type
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Loan Type - TEXT
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Lead Source
