Personal Loan Application

$
(Unsecured: $2,500 Minimum; Secured: $1,000 Minimum, both subject to special programs)
Section A - Individual Applicant Information
Separate values with a comma.
(number and street name)
(please select one)
$
(if applicable)
$
(if applicable)
(if less than 2 years at present address)
(please select one)
Self Employed borrower(s) may be required to provide additional documentation such as tax returns and financial statements.
(number and street name)
$
Sources of Other Income: Alimony, Child Support or Separate Maintenance Income need not be revealed if you choose not to have it considered for repaying this loan. Sources of other income may also include Social Security, Pensions, etc.
(Social Security, VA, Pensions, Alimony, or Child Support)
$
(if less than 2 years at current employment)
Section B - Joint Applicant or Other Party Information
Complete only if for joint credit, for individual credit relying on income or assets from other sources, or applicant is married and resides in a community property state.
Separate values with a comma.
(number and street name)
(please select one)
$
(if applicable)
$
(if applicable)
(if less than 3 years at present address)
(please select one)
Self Employed borrower(s) may be required to provide additional documentation such as tax returns and financial statements.
(number and street name)
$
Sources of Other Income: Alimony, Child Support or Separate Maintenance Income need not be revealed if you choose not to have it considered for repaying this loan. Sources of other income may also include Social Security, Pensions, etc.
(Social Security, VA, Pensions, Alimony, or Child Support)
$
(if less than 2 years at current employment)
(not living with you)
Section C - Marital Status
Complete only if for joint or secured credit or applicant resides in a community property state or is relying on property located in such a state as a basis for repayment of the credit requested.
Section D - Assets & Debt Information
If section B has been completed, please fill out both the Applicant and Joint Applicant Sections below. If Section B was not completed, only fill out the Applicant section.
Applicant Asset Information
Checking Account
$
Checking Account #2 (if applicable)
$
Savings Account
$
Savings Account #2 (if applicable)
$
Certificates of Deposit
$
Certificates of Deposit #2 (if applicable)
$
Real Estate Owned
Other Real Estate Owned (if applicable)
$
Life Insurance
$
$
$
$
Automobiles
$
Automobiles #2 (if applicable)
$
Other (i.e. Marketable Securities, Stocks, 401k)
$
$
$
Applicant Debt Information
Mortgage
$
$
$
Second Mortgage
$
$
$
Automobiles
$
$
$
$
$
$
Other Debt (credit card, department store, or credit union)
$
$
$
$
$
$
$
$
$
$
$
$
Section E - Declarations
Co-Applicant
Applicant

1. Are you a Co-Signer or Co-Maker on a Loan?

2. Are there any Outstanding Judgments Against You?

3. Have you been Declared Bankrupt in the past 7 Years?

4. Have you had a Foreclosure/Given Deed in Lieu in the Last 7 Years?

5. Are you a party to a Law Suit?

6. Are you a U.S. Citizen?

7. Are you required to pay alimony or child support?

If so, please include amount and to whom payable:

Amount:

$
$

To Whom Payable:

Section F - Secured Credit
Complete only if credit is to be secured. Briefly describe the collateral to be given as a security.
Names & Addresses of All Co-Owners of the Collateral:
Section G - Home Improvement
Address of Property Being Improved:
Race & Ethnicity
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. You may select one or more designations for "Race." The law provides that a lender may not discriminate on the basis of this information, or on whether you choose to furnish it.
ATS Payment
Would you like to set up Automatic Monthly Payments to your new loan account that can be drafted from your checking or savings account?
Signature

I certify that everything I have stated in this application is correct. You may keep this application whether or not it is approved. By signing below I authorize you to check on my credit and employment history and to answer questions others may ask you about my credit record with you. I understand that I must update credit information at your request if my financial condition changes. I also understand that I am executing this request for credit by electronic signature as defined by law, and I further understand that my electronic signature has the same force as a handwritten signature.

New York Residents Only: A consumer report may be requested in connection with this application or in connection with updates, renewals or extensions of any credit granted as a result of this application. Upon my request I will be informed whether or not a consumer credit report was requested, and if so, the name and address of the agency that furnished the report.

Ohio Residents Only: The Ohio laws against discrimination require that all creditors make credit equally available to all credit worthy customers and that credit reporting agencies maintain separate credit histories on each individual request. The Ohio Civil Rights Commission administers compliance with this law.

If this is an application for joint credit, first applicant and joint applicant each agree that we intend to apply for joint credit by signing below.

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