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Department of Finance

Credit Union Branch Application Form

Home » Financial Institutions Bureau » Credit Unions » Credit Union Forms » Credit Union Branch Application Form

Name of Credit Union:

Address of Credit Union:

Address

Street Address City State ZIP Code

Name & Title of Contact Person:

Address (if different from above)

Street Address City State ZIP Code

Telephone Number

BRANCH OFFICE DATA

On a separate page please submit the following information as part of your application for a branch office of your credit union:

Reason for the request. The credit union must justify that ninety percent (90%) of the cost of the branch and its operation will be derived from existing and potential membership in the proposed area.

Description of services to be provided at the proposed branch.

Proposed location of the branch office.

Estimated number of members the branch will serve.

Distance and geographical direction to the proposed branch from the head office.

Information to support the opinion there is a member need for the proposed branch in the area.

A physical description of the quarters to be occupied by the branch.

If the property is to be purchased, information as to the estimated cost.

If the property is to be leased, information as to the terms of the proposed lease and the estimated improvement costs, if any, to be incurred by the lessee.

Description of the vault, furniture, fixtures, and equipment for the proposed branch, along with a projection of their cost. If complete building plans have not been formulated for the branch, limits should be set on the expected investment in building, leasehold improvements, furniture, fixtures, and equipment.

Proposed opening date of the branch.

The approximate annual cost of operating the branch.

Impact the proposed branch office will have on the head office (indicate the credit union’s fixed asset investment).

Plans for staffing the proposed branch. Submit a resume of the proposed branch manager and indicate the number of and experience level of subordinate personnel.

Most recent month-end financial statements (include income and expenses).

An estimate of shares and loans for the first three years at the proposed branch. (See attached sample 3-year pro forma statement

An estimate of income and expenses for the first three years at the proposed branch. (See attached sample 3-year pro forma statement)

BOARD APPROVAL

The Idaho Credit Union Act § 26-2116(2)(h) establishes a special duty of the Board of Directors to authorize the conveyance of real property and buildings. Please certify by checking below that the Board of Directors has approved any purchase or sale of real property related to the proposed branch:

The Board of Directors has authorized all purchases or sales of real property related to this proposed branch.

SAMPLE PRO FORMA STATEMENT

Department of Finance

11341 West Chinden Blvd.
Building 4, Floor 3
Boise, ID 83714

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ver: 4.1.8 | last updated: May 28, 2025 at 12:36 pm