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FSB JOINT Personal Loan Application
Submitter Information (Required)
First Name (required)
Last Name (required)
Resolve the errors marked in red before submitting again.
Submitter Information

This application form is for a joint personal loan. Prefer to apply for an individual personal loan? Use this link to find our individual loan application.

Important Information about Procedures for Opening a New Account:
Identification Procedures Requirements: 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:
When you open an account, 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.

Security Notice:
You should ONLY fill out this form on-line if you are using a browser with the latest security enhancements. If you don't have the latest version, download a copy now. This form is NOT cached (saved in your computer's memory) when you QUIT your browser.

Type of Credit Requested
Type of Loan (required)
Amount Requested (required)
Term of Loan In Months (required)
Payment Date Desired
Proceeds of Loan to be Used For (required)
Referred By
Contact Information
Choose your location where you would like to complete your application (required)
How Would You Prefer to be Contacted? (required)
When is the best time to arrange an appointment? (required)
First Applicant Personal Information
First NameMiddle InitialLast Name
(required) (required) (required)
Social Security Number
000000000
(required) (required) (required)
Date of Birth (required)
Driver's License No.Driver's License State
(required) (required)
Phone (required)
Email (required)
Verify Email (required)
First Applicant Current Address
Home Address Not a P.O. Box (required)
County (required)
Years At Home Address (required)
Home Status (required)
First Applicant Previous Address
Previous Address Not a P.O. Box
Years At Previous Address
First Applicant Dependent and Relative Information:
Number of DependentsAge of Dependents

 

 
Relative Address Not a P.O. Box
Relative Phone Number
First Applicant Current Employer
Employer's NameEmployer's Phone
(required) (required)
Employers Address (required)
Your Position
Years at Company
First Applicant Previous Employer
Previous Employer's NamePrevious Employer Phone

 

 
Previous Employers Address
Years at Previous Company
First Applicant Income
Salary Per Month
Salary Per Month *Alimony, child support, or separate maintenance income need not be included if you do not wish to have it considered as a basis for repaying this obligation.
GrossNet
(required) (required)
First Applicant Other Income Sources
Alimony, child support, separate maintenance income received under:* (required)
*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.
Sources of Other Income
Amount Per Month
Is any income listed in this Section likely to be reduced before the credit request is paid off?
Have you previously received credit from us?
First 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.
First Applicant Asset & Debt Information - Checking Account
Checking Bank Name
Checking Bank Address
Name in Which the Account is Carried
Is this Account Subject to Debt?
First Applicant Asset & Debt Information - Savings Account
Savings Account Number
Savings Balance
Savings Bank Name
Savings Bank Address
Name in Which the Account is Carried
First Applicant Asset & Debt Information - Certificate of Deposit
Certificate of Deposit Value
Certificate of Deposit Bank Name
Certificate of Deposit Bank Address
Name in Which the Account is Carried
First Applicant Asset & Debt Information - Marketable Securities Assets
Marketable Securities Value
Issuer
Type
Number of Shares
Name in Which the Asset is Carried
First Applicant Asset & Debt Information - Real Estate Assets
Real Estate Address
Date Aquired
Name in Which the Asset is Carried
First Applicant Asset & Debt Information - Life Insurance Assets
Life Insurance Face Value
Issuer
Name in Which the Asset is Carried
First Applicant Asset & Debt Information - Automobile Assets
Automobile Value
MakeModelYear

 

 

 
Name in Which the Asset is Carried
First Applicant Asset & Debt Information - Other Assets
Value
Description
Name in Which the Asset is Carried
First Applicant Asset & Debt Information - Rent or Mortgage Payment
Rent or Mortgage Payment
Landlord or Mortgage Holder
Name in Which the Lease or Mortgage is Carried
Monthly PaymentOriginal Amount (Mortgage)Present Balance (Mortgage)

 

 

 
First Applicant Asset & Debt Information - Automobile Debt
Automobile Creditor If applicable
Loan Account Number
Automobile Information
Make Model Year

 

 

 
Name in Which the Loan is Carried
Original Amount
Present Balance
Monthly Payment
First Applicant Asset & Debt Information - Other Debt
Creditor
Account Number
Name in Which the Debt is Carried
Debt Information
Original AmountPresent BalanceMonthly Payment

 

 

 
First Applicant Secured Credit
Property Description
Co-Owner Name
Co-Owner Address
If the security is real estate, give the full name of your spouse if any
Co-Applicant Personal Information
First NameMiddle Initial Last Name
(required) (required) (required)
Social Security
000000000
(required) (required) (required)
Date of Birth (required)
Driver's License No.Driver's License State

 

 
Phone Number (required)
Email (required)
Verify Email (required)
Co- Applicant Current Address
Same as first applicant?
Home Address Not a P.O. Box
Years at Home
Home Status
Co-Applicant Previous Address
Same as first applicant?
Previous Address Not a P.O. Box
Years at Previous Address
Co-Applicant Dependent and Relative Information:
Same as first applicant?
Number of DependentsAge of Dependents

 

 
Relative Address Not a P.O. Box
Relative Phone Number (required)
Co-Applicant Current Employer
Employer's NameEmployer's Phone

 

 
Employers Address
Your Position (required)
Years at Company
Co-Applicant Current Employer
Previous Employer's NamePrevious Employer's Phone

 

 
Previous Employers Address
Years at Previous Company
Co-Applicant Income
Salary Per Month
*Alimony, child support, or separate maintenance income need not be included if you do not wish to have it considered as a basis for repaying this obligation.
GrossNet
(required) (required)
Co-Applicant Other Income Sources
Alimony, child support, separate maintenance income received under:*
*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.
Sources of Other Income (required)
Amount Per Month (required)
Is any income listed in this Section likely to be reduced before the credit request is paid off?
Have you previously received credit from us?
Co-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.
Co- Applicant Asset & Debt Information - Checking Account
Same as first applicant?
Checking Bank Name (required)
Checking Bank Address
Name in Which the Account is Carried (required)
Is this Account Subject to Debt?
Co- Applicant Asset & Debt Information - Savings Account
Same as first applicant?
Savings Account Number (required)
Savings Balance (required)
Savings Bank Name (required)
Savings Bank Address
Name in Which Account is Carried (required)
Co-Applicant Asset & Debt Information - Certificate of Deposit
Same as first applicant?
Certificate of Deposit Value (required)
Certificate of Deposit Bank Name (required)
Certificate of Deposit Bank Address
Name in Which the Account is Carried (required)
Co-Applicant Asset & Debt Information - Marketable Securities Assets
Same as first applicant?
Marketable Securities Value (required)
Issuer (required)
Type (required)
Number of Shares (required)
Name in Which the Asset is Carried (required)
Co-Applicant Asset & Debt Information - Real Estate Assets
Same as first applicant?
Real Estate Address
Date Aquried (required)
Name in Which the Asset is Carried (required)
Co-Applicant Asset & Debt Information - Life Insurance Assets
Same as first applicant?
Life Insurance Face Value (required)
Issuer (required)
Name in Which the Asset is Carried (required)
Co-Applicant Asset & Debt Information - Automobile Assets
Same as first applicant?
Automobile Value (required)
MakeModelYear

 

 

 
Name in Which the Asset is Carried (required)
Co-Applicant Asset & Debt Information - Other Assets
Same as first applicant?
Value (required)
Description (required)
Name in Which the Asset is Carried (required)
Co-Applicant Asset & Debt Information - Rent or Mortgage Payment
Same as first applicant?
Rent or Mortgage Payment
Landlord or Mortgage Holder (required)
Name in Which the Lease or Mortgage is Carried (required)
Monthly PaymentOriginal Amount (Mortgage)Present Balance (Mortgage)

 

 

 
Co- Applicant Asset & Debt Information - Automobile Debt
Same as first applicant?
Automobile Creditor if applicable (required)
Loan Account Number (required)
Automobile Information
MakeModelYear

 

 

 
Name in Which the Loan is Carried (required)
Original Balance (required)
Present Balance (required)
Monthly Payment (required)
Co-Applicant Asset & Debt Information - Other Debt
Same as first applicant?
Creditor (required)
Account Number (required)
Name in Which the Debt is Carried (required)
Debt Information
Original AmountPresent BalanceMonthly Payment

 

 

 
Co- Applicant Secured Credit
Same as first applicant?
Property Description (required)
Co-Owner Name (required)
Co-Owner Address
If the security is real estate, give the full name of your spouse if any (required)
Applicant(s) Statement

By clicking Submit below, I/we certify that everything stated in this application is correct. Flanagan State Bank may keep this application whether or not it is approved. By submitting this application I/we authorize Flanagan State Bank to check my/our credit and employment history and to answer questions others may ask Flanagan State Bank about my credit record with Flanagan State Bank. I/we understand that I/we must update credit information at the request of Flanagan State Bank if my financial condition changes. 

(required)