Loan Pre-Application

Loan Pre-Application Form

"*" indicates required fields

Step 1 of 2

Application Type*

Individual

Joint Application

Branch*

Loan Amount Requested*

Purpose of the Loan*

Employer's Name*

Address (APT#, Unit, Suite, Etc.)*

City*

State*

Zip Code*

Employer's Phone*

Your Position*

How Long?*

Gross Monthly Income*

Net Monthly Income*

Please Provide Information About Your Previous Employers if You Have Been Working Here for Less Than 3 Years.

Select Your Closest Loan Office*

Bank Reference*

Accounts:*

Checking

Savings

Marital Status:*

Single

Married

Separated

How Long?*

Number in Family*

Tell Us About Your Residence*

Tell Us About Your Cars and / or Boats*

Tell Us About Any Other Sources of Income*

Equal Credit Opportunity

The Federal Credit Opportunity Act prohibits creditors from discriminating against credit applicants on the basis of race, color, religion, national origin, sex, marital status, age (provided that the applicant has the capacity to enter into a binding contract); because all or part of the applicant's income derives from any public assistance program,; or because the applicant has in good faith exercised any right under the Consumer Credit Protection Act. The federal agency that administers compliance with this law concerning this creditor is the Federal Trade Commission, 633 Indiana Avenue, NW, Washington DC 20580.

Permissions

For the purposes of obtaining credit the applicant(s) hereby warrants and affirms that each of the answers given to the foregoing questions is true and correct. The applicant(s) expressly authorizes the creditor to make inquiries of others conceming the foreacina information and to provide informetion arising out of the applicant's transactions with the creditor. Any person or entity named herein is expressly authorized to furnish the creditor with information in connection with this application.