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Consumer Loan Application

I. TYPE OF LOAN

Select all that apply *

II. APPLICANT INFORMATION

Account *
calendar
Marital Status *
calendar
Same as Borrower's Address *
Marital Status *
Is your mailing address different than your present address? *

III. EMPLOYMENT/INCOME INFORMATION

Borrower Employment Type *
Co-Borrower Employment Type *
*Self Employed Applicant(s) may be required to provide additional documentation such as tax returns and financial statements.
NOTICE:  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.

IV. HOUSING INFORMATION

V. ASSETS

Checking & Savings Accounts
Stocks and Bonds
Do you have stocks or bonds? *
Automobiles Owned
Real Estate Owned

VI. LIABILITIES

List the creditor's name, address and account number for all outstanding debts, including automobile loans, revolving charge accounts, real estate loans, alimony, child support, stock pledges, etc. 
Alimony/Child Support/Separate Maintenance Payments
Are you required to pay alimony, child support or separate maintenance payments? *

VII. AUTHORIZATIONS & DISCLOSURES

ELECTRONIC DISCLOSURE AUTHORIZATION

The Electronic Disclosure and Consent contains important information that you are entitled to receive before you consent to transact business with us electronically. Please read this notice and print or download a copy for your files.
Applicant
I have read and agree to accept account disclosures online and affirmatively consent to receive the required disclosures in electronic form, including disclosures required by the Truth in Lending Act, Real Estate Settlement Procedures Act and Equal Credit Opportunity Act. Paper copies will be provided for certain real estate related transactions after your loan application is received. I also agree to receive communications regarding the status of my application electronically via the email address provided with the online application. *
Co-Applicant
I have read and agree to accept account disclosures online and affirmatively consent to receive the required disclosures in electronic form, including disclosures required by the Truth in Lending Act, Real Estate Settlement Procedures Act and Equal Credit Opportunity Act. Paper copies will be provided for certain real estate related transactions after your loan application is received. I also agree to receive communications regarding the status of my application electronically via the email address provided with the online application. *

CREDIT CHECK AUTHORIZATION

Applicant
I hereby grant permission for you to obtain all information deemed necessary to process your loan application. This information includes, but is not limited to, your past and present employment status, your deposit accounts, your past and present consumer credit record, your mortgage record and/or your rental record. *
Co-Applicant
I hereby grant permission for you to obtain all information deemed necessary to process your loan application. This information includes, but is not limited to, your past and present employment status, your deposit accounts, your past and present consumer credit record, your mortgage record and/or your rental record. *

PATRIOT ACT

Applicant
To help the government fight the funding of terrorism and money laundering activities, Federal Law requires all financial institutions to obtain, verify, and record information that identifies each person who opens an account. What this means for you: As part of applying for your loan, we will ask for your name, address, date of birth and other information that will allow us to identify you. We may also ask to see your driver's license or other identifying documents. *
Co-Applicant
To help the government fight the funding of terrorism and money laundering activities, Federal Law requires all financial institutions to obtain, verify, and record information that identifies each person who opens an account. What this means for you: As part of applying for your loan, we will ask for your name, address, date of birth and other information that will allow us to identify you. We may also ask to see your driver's license or other identifying documents. *

MILITARY LENDING ACT

Federal law provides important protections to active duty members of the Armed Forces and their dependents. To ensure that these protections are provided to eligible applicants, we require you to select one of the following statements as applicable.
 
Warning: It is important to fill out this section accurately. Knowingly making a false statement on a credit application is a crime.
Applicant *
Co-Applicant *

INFORMATION FOR GOVERNMENT MONITORING PURPOSES

The following information is requested by the Federal Government for certain types of loans related to a dwelling in order to monitor the lender's compliance with equal credit opportunity, fair housing and home mortgage disclosure laws. You are not required to furnish this information, but are encouraged to do so. The law provides that a lender may not discriminate either on the basis of this information, or on whether you choose to furnish it. If you furnish the information, please provide both ethnicity and race. For race, you may check more than one designation. If you do not furnish ethnicity, race, or sex, under Federal regulations, this lender is required to note the information on the basis of visual observation and surname if you have made this application in person. If you do not wish to furnish the information, please check the box below. (Lender must review the above material to assure that the disclosures satisfy all requirements to which the lender is subject under applicable state law for the particular type of loan applied for.)
Ethnicity (check one or more) *
Hispanic or Latino *
Race (check one or more) *
Asian *
Native Hawaiian or Other Pacific Islander *
Sex *
Co-Borrower
Ethnicity (check one or more) *
Hispanic or Latino *
Race (check one or more) *
Asian *
Native Hawaiian or Other Pacific Islander *
Sex *

NOTICE OF RIGHT TO RECEIVE A COPY OF APPRAISAL

We may order an appraisal to determine the property's value and charge you for this appraisal. We will promptly give you a copy of any appraisal, even if your loan does not close.  You can pay for an additional appraisal for your own use at your own cost.
Applicant *
Co-Applicant *

JOINT APPLICATION ACKNOWLEDGMENT

We intend to apply for joint credit. *

APPLICANT SIGNATURES

I/We hereby apply for the loan or credit described in this application. I/We certify, that I/We made no misrepresentations in this loan application or in any related documents, that all information is true and complete, and that I/We did not omit any important information. I/We agree that any property securing the loan or credit will not be used for any illegal or restricted purposes. Lender is authorized to verify with other parties and to make any investigation of my/our credit, either directly or through any agency employed by Lender for that purpose. Lender may disclose to any other interested parties information as to Lender's experience or transactions with my/our account. I/We understand that Lender will retain this application and any other credit information Lender receives, even if no loan or credit is granted. There representations and authorizations extend not only to Lender, but also to any insurer of the loan and to any investor to whom Lender may sell or any part of the loan. I/We further authorize Lender to provide any such insurer or investor any information and documentation that they may request with respect to my/our application, credit or loan.

BRANCH & LOAN OFFICER INFORMATION

Are you an existing customer? *
Your application request will be submitted into a secure, encrypted website in order to protect your confidential information.