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Loan Application

IMPORTANT: Please read these directions before completing this Application, and check the appropriate box below.


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Application Info*
Section A - Information Regarding Applicant
Personal Information
Present Address
Previous Address
Nearest Relative
Your relationship to us
Have you ever received credit from us?
Present Employment
Previous Employment
Other income to be used for repayment such as alimony, child support, other maintenance:
Section B - Information Regarding Joint Applicant or Other Party
Personal Information
Present Address
Previous Address
Nearest Relative
Your relationship to us
Have you ever received credit from us?
Present Employment
Previous Employment
Other income to be used for repayment such as alimony, child support, other maintenance:
Section C - Marital Status
Applicant
Other Party
Section D - Asset & Debt Information

If section B has been completed, this section should be completed giving information about both the Applicant and Joint Applicant or Other Person. If Section B was not completed, only give information about the Applicant in this section.

Assets Owned
Checking Account(s)
Savings Account(s)
Automobiles
Other Assets
Cash Value of Life Insurance
Real Estate
Stocks/Bonds

Outstanding Debts (Include charge accounts, installment contracts, credit cards, rent, mortgages, etc. Use separate sheet if necessary).

Liabilities
Credit References (Paid off Accounts)
Section E - Secured Credit

If applicable, please complete:

Secured Credit Information

Acknowledgements

Everything that I have stated in this application is correct to the best of my knowledge. I understand that you will retain this Application whether or not it is approved. You are authorized to check my credit and employment history and to ask questions about any credit experience with me.

Applicant Signature
Co-Applicant Signature

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

The lender may not condition an extension of credit on either:
1) My purchase of an insurance product of annuity from the lender of any of its affiliates; or
2) My agreement not to obtain, or a prohibition on me from obtaining, an insurance product or annuity from an unaffiliated entity.

Thank you for your submission!

We will be in touch with you soon.

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