JOINT Personal Loan Application Flanagan State Bank

Submitter Information(Required)

First Last

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

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Type of Credit Requested

Type of Loan(Required)

Secured

Unsecured

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)

Phone

Mail

When is the best time to arrange an appointment?(Required)

Morning

Lunchtime

Afternoon

First Applicant Personal Information

Name(Required)

First Middle Last

Social Security Number(Required)

Date of Birth(Required)

Driver's License No.(Required)

Driver's License State(Required)

Phone(Required)

Email(Required)

Enter Email Confirm Email

First Applicant Current Address

Home Address Not a P.O. Box(Required)

Street Address Address Line 2 City State ZIP Code

County(Required)

Years At Home Address(Required)

Home Status(Required)

Own

Rent

Other

First Applicant Previous Address

Previous Address Not a P.O. Box

Street Address Address Line 2 City State ZIP Code

Years At Previous Address

First Applicant Dependent and Relative Information:

Number of Dependents

Age of Dependents

Relative Address Not a P.O. Box

Street Address Address Line 2 City State ZIP Code

Relative Phone Number

First Applicant Current Employer

Employer's Name(Required)

Employer's Phone(Required)

Employers Address(Required)

Street Address Address Line 2 City State ZIP Code

Your Position

Years at Company

First Applicant Previous Employer

Previous Employer's Name

Previous Employer Phone

Previous Employers Address

Street Address Address Line 2 City State ZIP Code

Years at Previous Company

First Applicant Income

*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.

Salary per Month* (Gross)(Required)

Salary per Month* (Net)(Required)

First Applicant Other Income Sources

*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.

Alimony, child support, separate maintenance income received under:*(Required)

None

Court Order

Written

Oral Understanding

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?

Yes

Have you previously received credit from us?

Yes

First Applicant 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.

Marital Status

Married

Separated

Unmarried

Not Applicable

First Applicant Asset & Debt Information - Checking Account

Checking Bank Name

Checking Bank Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Name in Which the Account is Carried

Is this Account Subject to Debt?

Yes

First Applicant Asset & Debt Information - Savings Account

Savings Account Number

Savings Balance

Savings Bank Name

Savings Bank Address

Street Address Address Line 2 City State ZIP Code

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

Street Address Address Line 2 City State ZIP Code

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

Street Address Address Line 2 City State ZIP Code

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

Make

Model

Year

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

Rent

Mortgage

Landlord or Mortgage Holder

Name in Which the Lease or Mortgage is Carried

Monthly Payment

Original Amount (Mortgage)

Present Balance (Mortgage)

First Applicant Asset & Debt Information - Automobile Debt

Automobile Creditor If applicable

Loan Account Number

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

Original Amount

Present Balance

Monthly Payment

First Applicant Secured Credit

Property Description

Co-Owner Name

Co-Owner Address

Street Address Address Line 2 City State ZIP Code

If the security is real estate, give the full name of your spouse if any

Co-Applicant Personal Information

Name(Required)

First Middle Last

Social Security(Required)

Date of Birth(Required)

Driver's License No.

Driver's License State

Phone Number(Required)

Email(Required)

Enter Email Confirm Email

Co- Applicant Current Address

Same as first applicant?(Required)

Yes

Home Address Not a P.O. Box

Street Address Address Line 2 City State ZIP Code

Years at Home

Home Status

First Choice

Second Choice

Third Choice

Co-Applicant Previous Address

Same as first applicant?(Required)

Yes

Previous Address Not a P.O. Box

Street Address Address Line 2 City State ZIP Code

Years at Previous Address

Co-Applicant Dependent and Relative Information:

Same as first applicant?(Required)

Yes

Number of Dependents

Age of Dependents

Relative Address Not a P.O. Box

Street Address Address Line 2 City State ZIP Code

Relative Phone Number(Required)

Co-Applicant Current Employer

Employer's Name

Employer's Phone

Employers Address

Street Address Address Line 2 City State ZIP Code

Your Position

Years at Company

Co-Applicant Previous Employer

Previous Employer's Name

Previous Employer's Phone

Previous Employers Address

Street Address Address Line 2 City State ZIP Code

Years at Previous Company

Co-Applicant Income

*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.

Salary per Month* (Gross)(Required)

Salary per Month* (Net)

Co-Applicant Other Income Sources

*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.

Alimony, child support, separate maintenance income received under:*

None

Court Order

Written

Oral Understanding

Sources of Other Income(Required)

Amount Per Month

Is any income listed in this Section likely to be reduced before the credit request is paid off?

Yes

Have you previously received credit from us?

Yes

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.

Marital Status

Married

Separated

Unmarried

Not Applicable

Co- Applicant Asset & Debt Information - Checking Account

Same as first applicant?(Required)

Yes

Checking Bank Name(Required)

Checking Bank Address

Street Address Address Line 2 City State ZIP Code

Name in Which the Account is Carried(Required)

Is this Account Subject to Debt?

Yes

Co- Applicant Asset & Debt Information - Savings Account

Same as first applicant?(Required)

Yes

Savings Account Number(Required)

Savings Balance(Required)

Savings Bank Name(Required)

Savings Bank Address

Street Address Address Line 2 City State ZIP Code

Name in Which Account is Carried(Required)

Co-Applicant Asset & Debt Information - Certificate of Deposit

Same as first applicant?(Required)

Yes

Certificate of Deposit Value(Required)

Certificate of Deposit Bank Name(Required)

Address

Street Address Address Line 2 City State ZIP Code

Name in Which the Account is Carried(Required)

Co-Applicant Asset & Debt Information - Marketable Securities Assets

Same as first applicant?(Required)

Yes

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?(Required)

Yes

Address

Street Address Address Line 2 City State ZIP Code

Date Acquired(Required)

Name in Which the Asset is Carried(Required)

Co-Applicant Asset & Debt Information - Life Insurance Assets

Same as first applicant?(Required)

Yes

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?(Required)

Yes

Automobile Value(Required)

Make

Model

Year

Name in Which the Asset is Carried(Required)

Co-Applicant Asset & Debt Information - Other Assets

Same as first applicant?(Required)

Yes

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?(Required)

Yes

Rent or Mortgage Payment

Rent

Mortgage

Landlord or Mortgage Holder(Required)

Name in Which the Lease or Mortgage is Carried(Required)

Monthly Payment

Original Amount (Mortgage)

Present Balance (Mortgage)

Co- Applicant Asset & Debt Information - Automobile Debt

Same as first applicant?(Required)

Yes

Automobile Creditor if applicable(Required)

Loan Account Number(Required)

Make

Model

Year

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?(Required)

Yes

Creditor(Required)

Account Number(Required)

Name in Which the Debt is Carried(Required)

Original Amount

Present Balance

Monthly Payment

Co-Applicant Secured Credit

Same as first applicant?(Required)

Yes

Property Description(Required)

Co-Owner Name(Required)

Address

Street Address Address Line 2 City State ZIP Code

If the security is real estate, give the full name of your spouse if any(Required)

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