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FSB Personal Loan Application
Submitter Information
First Name (required)
Last Name (required)
Resolve the errors marked in red before submitting again.
Type of Loan (required)
Individual or Joint (required)
Amount Requested (required)
Term of Loan In Months (required)
Payment Date Desired
Proceeds of Loan to be Used For (required)
Referred By
First NameMiddle InitialLast Name

 
Social Security Number
000000000

 
Date of Birth (required)
Driver's License No.Driver's License State

 
Phone (required)
Email (required)
Verify Email (required)
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)
Home Address Not a P.O. Box (required)
County (required)
Years At Home Address (required)
 
 
Home Status (required)
Previous Address Not a P.O. Box
Years At Previous Address
 
 
Number of DependentsAge of Dependents

 
Relative Address Not a P.O. Box
Relative Phone Number
Employer's NameEmployer's Phone

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

 
Previous Employers Address
Years at Previous Company
 
 
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

 
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?
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 Marital Status
Checking Bank Name
Checking Bank Address
Name in Which the Account is Carried
Is this Account Subject to Debt?
Savings Account Number
Savings Balance
Savings Bank Name
Savings Bank Address
Name in Which the Account is Carried
Certificate of Deposit Value
Certificate of Deposit Bank Name
Certificate of Deposit Bank Address
Name in Which the Account is Carried
Marketable Securities Value
Issuer
Type
Number of Shares
Name in Which the Asset is Carried
Real Estate Address
Date Aquired
Name in Which the Asset is Carried
Life Insurance Face Value
Issuer
Name in Which the Asset is Carried
Automobile Value
MakeModelYear

 
Name in Which the Asset is Carried
Value
Description
Name in Which the Asset is Carried
Rent or Mortgage Payment
Landlord or Mortgage Holder
Name in Which the Lease or Mortgage is Carried
Monthly PaymentOriginal Amount (Mortgage)Present Balance (Mortgage)

 
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
Creditor
Account Number
Name in Which the Debt is Carried
Debt Information
Original AmountPresent BalanceMonthly Payment

 
Property Description
Co-Owner Name
Co-Owner Address
If the security is real estate, give the full name of your spouse if any
(required)