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

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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Applicant's Information
First NameLast NameDate of BirthSocial Security Number

Phone NumberAlternate Phone NumberEmail

Principal Address (required)
Own With MortgageOwn OutrightRentOther

Years At Principal AddressMonthly Rent or Mortgage Payment

Previous Address (If years at Principal Address is less than 2 years)
Borrower's Employment and Income Information

Your Current EmployerPhone

Gross Monthly SalaryYour PositionYears There

You do not have to list alimony, child support or separate maintenance income unless you want us to consider it for the purposes of granting and repayment of this credit request.
Other Monthly IncomeSource of Other Income

Your Previous Employer (if less than 2 years with Current Employer
Previous EmployerPhoneYears There

Auto Loan Details
Amount RequestedDesired Monthly PaymentDesired term (in months)

If you have already selected the vehicle you would like to purchase, please provide the information below.

Additional Information
Deposit Account(s)

Deposit Account Banks or other Financial Institutions
Institution Name
Co Applicant Information (Optional)
First NameLast NameDate of BirthSocial Security Number
Co Applicant
Applicant(s) Statement

Applicant(s) Statement 
I / we have completed this request for credit in consideration of Flanagan State Bank lending to me and/or others upon my guarantee. I certify that all information contained herein is accurate and complete to the best of my knowledge.

I authorize Flanagan State Bank to retain property of this application, to rely on the foregoing, to check and verify my credit, employment and salary history, to secure follow up credit reports concerning my credit worthiness and to exchange information about my account with proper persons, creditors and credit bureaus.

I authorize my employer (present and future), bank and other references listed above to release and/or verify information to Flanagan State Bank at any time. I acknowledge that this application is subject to approval of credit and acceptance by Flanagan State Bank. Should my request for credit and subsequent loan be approved, I agree to give Flanagan State Bank written notice immediately upon change of my name, address, employment or any other pertinent information contained herein.