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:
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Instructions:
1. Print this loan application and gather the information you'll need.
2. Complete application on-line and click "Submit Application"
3. To safeguard your privacy, QUIT your browser and restart it again after using this form.
This loan application is for personal loans only and is NOT intended for commercial use. A valid social security number is required to apply. Please review and gather the information you will need before completing this form. Upon receipt of the application, we will send you the proper disclosures.
| Applicant Initials | Co-Applicant Initials | |
|---|---|---|
| Year of Vehicle | Make | Model | |
|---|---|---|---|
| Purchase Price | Down Payment | Finance Amount | |
|---|---|---|---|
| First Name | Middle Initial | Last Name | |
|---|---|---|---|
| Date of Birth | Social Security No. | No. of Dependents | |
|---|---|---|---|
| Driver's License No. | Driver's License State | Your E-mail Address | |
|---|---|---|---|
| Home Phone | Best Time to Call | Work Phone | |
|---|---|---|---|
| Years At Present Address | Your Monthly rate or Mortgage Payment | |
|---|---|---|
| Years At Previous Address | Your Previous Address | |
|---|---|---|
| Collateral Property Address (If different from above) | Date Purchased | |
|---|---|---|
| Current Mortgage Holder | Mortgage Holder Phone | |
|---|---|---|
| Purchase Price | Market Value | Mortgage Balance | |
|---|---|---|---|
| Your Present Employer | Phone | |
|---|---|---|
| Gross Monthly Salary | Your Position | Years There | |
|---|---|---|---|
You do not have to list alimony, child support, separate maintenance, medical insurance, or disability or wage continuation insurance income unless you want us to consider it for the purposes of granting and repayment of this credit request.
| Other Monthly Income | Source of Other Income | |
|---|---|---|
| Previous Employer (if less than 3 years at current employer) | Years at Previous Employer | |
|---|---|---|
If married applicants are applying for Joint Credit, include all property of both spouses requested below.
If a married applicant is applying for Individual Credit or for Joint Credit with someone other than his or her spouse, include all marital property and all individual property of the applicant spouse requested below, but do not include individual property of the other spouse. A married applicant must in every case identify the liabilities of both spouses.
For purposes of this application:
Marital property means assets acquired with income of either spouse on or after 1-1-86; and, individual property means property owned (whether in sole or joint name) by the named spouse prior to marriage, prior to establishing residence in Wisconsin, or prior to 1-1-86, however acquired, and property acquired by named spouse by gift or inheritance at any time.
| Your Checking Account Number | Institution Name | |
|---|---|---|
| Your Savings Account Number | Institution Name | |
|---|---|---|
| Name of Creditor | Approx. Balance | Monthly Payment | Collateral, if any | |
|---|---|---|---|---|
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| Assets | Value | Title Held Name | |
|---|---|---|---|
| First Name | Middle Initial | Last Name | |
|---|---|---|---|
| Date of Birth | Social Security No. | No. of Dependents | |
|---|---|---|---|
| Driver's License No. | Driver's License State | Your E-mail Address | |
|---|---|---|---|
| Home Phone | Best Time To Call | Work Phone | |
|---|---|---|---|
| Years At Present Address | Your Monthly Rent or Mortgage Payment | |
|---|---|---|
| Years At Previous Address | Your Previous Address | |
|---|---|---|
| Collateral Property Address (If different from above) | Date Purchased | |
|---|---|---|
| Current Mortgage Holder | Mortgage Holder Phone | |
|---|---|---|
| Purchase Price | Market Value | Mortgage Balance | |
|---|---|---|---|
| Your Present Employer | Phone | |
|---|---|---|
| Gross Monthly Salary | Your Position | Years There | |
|---|---|---|---|
You do not have to list alimony, child support, separate maintenance, medical insurance, or disability or wage continuation insurance income unless you want us to consider it for the purposes of granting and repayment of this credit request.
| Other Monthly Income | Source of Other Income | |
|---|---|---|
| Previous Employer (if less than 3 years at current employer) | Years at Previous Employer | |
|---|---|---|
If married applicants are applying for Joint Credit, include all property of both spouses requested below.
If a married applicant is applying for Individual Credit or for Joint Credit with someone other than his or her spouse, include all marital property and all individual property of the applicant spouse requested below, but do not include individual property of the other spouse. A married applicant must in every case identify the liabilities of both spouses.
For purposes of this application:
Marital property means assets acquired with income of either spouse on or after 1-1-86; and, individual property means property owned (whether in sole or joint name) by the named spouse prior to marriage, prior to establishing residence in Wisconsin, or prior to 1-1-86, however acquired, and property acquired by named spouse by gift or inheritance at any time.
| Your Checking Account Number | Institution Name | |
|---|---|---|
| Your Savings Account Number | Institution Name | |
|---|---|---|
| Name of Creditor | Approx. Balance | Monthly Payment | Collateral, if any | |
|---|---|---|---|---|
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| Assets | Value | Title Held Name | |
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NOTICE TO MARRIED APPLICANTS: No provision of any marital property agreement, unilateral statement under s.766.59, Wis. Stats., or court decree under s766.70, Wis. Stats., adversely affects the interest of the creditor unless the creditor, prior to the time the credit is granted or an open-end credit plan is entered into, is furnished a copy of the agreement, statement or decree or has actual knowledge of the adverse provision.
NOTICE: We may report information about your account to credit bureaus. Late payments, missed payments, or other defaults on your account may be reflected in your credit report.
For the purpose of obtaining the credit described above, and any future credit granted to the undersigned by the creditor named above, the undersigned, jointly and severally, (1) represent that the above statements are true and complete, (2) authorize the creditor named above, or its agents, to verify them and obtain additional information concerning our credit, employment history or any other information, including credit reports (although creditor may rely on these statements without any further verification), to furnish, to the extent not prohibited by applicable law, credit experience with me to others, and to answer any questions about our credit experience and other financial relationships with the creditor, and (3) agree to the provisions of any rules, regulations or agreements of the creditor governing such credit. This application is creditor's property.
The undersigned understand that it may be a federal crime punishable by fine or imprisonment or both to knowingly make any false statements concerning any of the above facts.
IMPORTANT INFORMATION ABOUT PROCEDURES FOR OBTAINING CREDIT: 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 obtains credit. What this means for you: When you obtain credit, we will ask you 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.