couple using computer

Loan Application

Sample Heading H2

This is an area for content (optional). Fusce in velit sit amet ante scelerisque viverra. Praesent non nibh ac nisi iaculis accumsan vel vitae felis. In id tortor magna, vel accumsan diam. Suspendisse potenti. Aliquam bibendum volutpat augue, consectetur fringilla nulla suscipit facilisis. Aliquam lobortis rhoncus adipiscing. Pellentesque tincidunt tristique ipsum, consequat accumsan tellus pretium sed.
* Required Fields
Step 1 of 6, or 7 if applying Jointly

Credit Request Information

Application Type *
Type of Credit *

Primary Applicant Information

Primary Applicant Driver's License Information

Primary Applicant Address Information

Primary Applicant Address Own or Rent? *

Primary Applicant Previous Address Information

Complete if less than 3 years at current address.

Primary Applicant Previous Address Own or Rent?

Primary Applicant Employment Information

Primary Applicant Previous Employment Information

Primary Applicant Reference

Name and address of nearest relative not living with you

Primary Applicant Additional Income Information

Alimony, child support, or separate maintenance income need not be revealed if you do not wish to have it considered as a basis of repaying this obligation.

Primary Applicant Alimony, child support, separate maintenance received under:
Primary Applicant Is any income listed in this section likely to be reduced before the credit request is paid off?
Primary Applicant Have you previously received credit from us?

Primary Applicant 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.

Primary Applicant Marital Status

Primary Applicant Additional Information

Primary Applicant Are you a co-maker, endorser, or guarantor on any loan or contract? *
Primary Applicant Are there any unsatisfied judgements against you? *
Primary Applicant Have you been declared bankrupt in the last 10 years? *
Primary Applicant Are you obligated to make Alimony, Support, or Maintenance Payments? *

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.

Joint or Other Applicant Driver's License Information

Joint or Other Applicant Address Information

Joint or Other Applicant Employment Information

Joint or Other Applicant Previous Employment Information

Joint or Other Applicant Additional Income Information

Alimony, child support, or separate maintenance income need not be revealed if you do not wish to have it considered as a basis of repaying this obligation.

Joint or Other Applicant Alimony, child support, separate maintenance received under:
Joint or Other Applicant Is any income listed in this section likely to be reduced before the credit request is paid off?
Joint or Other Applicant Have you previously received credit from us?

Joint or Other Applicant 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.

Joint or Other Applicant Marital Status

Joint or Other Applicant Additional Information

Joint or Other Applicant Are you a co-maker, endorser, or guarantor on any loan or contract? *
Joint or Other Applicant Are there any unsatisfied judgements against you? *
Joint or Other Applicant Have you been declared bankrupt in the last 10 years? *
Joint or Other Applicant Are you obligated to make Alimony, Support, or Maintenance Payments? *

Assets

If applying Jointly, or applying as Individual Applicant with income or assets from other sources, this section should be completed giving information about both the Applicant and Joint Applicant or Other Person. Please mark Primary Applicant-related information with an "A". If multiple accounts and/or owners, list all, and use commas to separate.

Assets Information
TypeDescriptionOwnerSubject to DebtValue
Checking Accounts
Subject to Debt?
Savings Accounts
Subject to Debt?
Marketable Securities
Subject to Debt?
Real Estate
Subject to Debt?
Life Insurance
Subject to Debt?
Automobiles
Subject to Debt?
Other
Subject to Debt?
Total

Outstanding Debts

Include charge accounts, installment contracts, credit cards, rent, mortgages, etc.

Landlord or Mortgage Holder

Housing Debt Payment Details

Automobiles

Other

Other Debt 2

Other Debt 3

Other Debt 4

Debt Totals

Secured Credit

Names and Addresses of All Co-Owners of the Property

Property Co-Owner 1
Property Co-Owner 2
Property Co-Owner 3
Property Co-Owner 4

If the security is real estate, give the full name of your spouse (if any)

Sign and Submit Application

Notices

Notice to All Applicants. A Consumer Report may be requested in connection with this application for credit or any future update, renewal, or extension of such credit. Upon request, you will be informed whether or not a consumer report was requested. If a report was requested, you will be informed of the name and address of the consumer reporting agency that furnished the report.

Notice to Ohio Residents. 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 upon request. The Ohio civil rights commission administers compliance with this law.

Notice to Wisconsin Residents - Marital Property Agreement Notice. No provision of any marital property agreement, unilateral statement under Wisconsin Statutes Section 766.59 or court decree under Wisconsin Statues Section 766.70 adversely affects the interest of the creditor unless the creditor, prior to the time the credit is granted, is furnished a copy of the agreement, statement or decree or has actual knowledge of the adverse provision when the obligation to the creditor is incurred.

Signatures

I certify that everything I have stated in this application and on any attachments is correct. Lender may keep this application whether or not it is approved. By signing below I authorize Lender to check my credit and employment history and to answer questions others may ask Lender about my credit record with Lender. I understand that I must update credit information at Lender's request if my financial condition changes.

Success! We have received your application and we will be in touch soon.