Loan application

 

IMPORTANT APPLICANT INFORMATION: Federal law requires financial institutions to obtain sufficient information to verify your identity. You may be asked several questions and to provide one or more forms of identification to fulfill this requirement. By submitting this application, you agree to an electronic signature. However, we may not be able to disburse funds without obtaining an original signature authorizing your personal loan request. The information you provide is protected by our privacy policy and federal law.


Type of Credit Requested

Type of Loan

Amount Request

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Loan Proceeds Use


Individual Applicant Information

Last Name

Address

Zip

Home Phone

Last Name

First Name

City

County

Cell Phone

MI

State

Do You

Monthly Housing Payment

If you are a renter, please list the name of your landlord or apartment complex.

How long have you lived at your current residence?

*

Individual Applicant Other Assets

Please list the dollar amount of any savings or money market accounts, cds, stocks, or other real estate in your name:


Individual Applicant Employment Information

Employer Name

 

Business Phone

Employer Address

If checked, please explain reason:


Position/Title

For How Long?

(per mo.)

Prior Employment: If you have been employed with your current employer less than one year, please provide your prior employment information below:

Prior Employer

Prior Business Phone

Prior Employer Address

Prior Position/Title

For How Long?


Individual Applicant - 1st Personal Reference

Last Name

State

First Name

Zip

Address

Home Phone

City

Please Note: Your personal references you chose to list should be family members and not friends


Individual Applicant - 2nd Personal Reference

Last Name

State

First Name

Zip

Address

Home Phone

City

Please Note: Your personal references you chose to list should be family members and not friends


Co-Applicant Information

Relationship to Primary Applicant

Last Name

Address

Zip

First Name

City

County

MI

State

Do You

If you are a renter, please list the name of your landlord or apartment complex.

How Long have you lived at your current residence?

Home Phone

DOB

Email Address

Cell Phone

SSN

Driver's License #

Monthly Housing Payment

Est. Home Value (if owned)

State


Co-Applicant Other Assets

Please list the dollar amount any money market accts, cd’s, stocks, other real estate in your name.


Co-Applicant Employment Information

Employer Name

Business Phone

Employer Address

Position/Title

For How Long?

Gross Salary (per mo.)

Prior Employment: If you have been employed with your current employer less than one year, please provide your prior employment information below:

Prior Employer

Prior Business Phone

Prior Employer Address

Prior Position/Title

For How Long?


Co-Applicant Personal Reference

Last Name

State

First Name

Zip

Address

Home Phone

City

Please Note: Your personal references you chose to list should be family members and not friends


Secured Credit Request

Complete if you will be using a vehicle or cash as collateral for your loan.
Briefly describe the property to be given as security.

Property Description (vehicle type or amount of cash)

Names & Addresses of all Co-Owners of the Property

Comments

Please add any appropriate comments that will help us understand your loan request.

ELECTRONIC SIGNATURES:

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

*
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