Home Loan Application Form
Branch Location
*
Rochester
Red Wing
Type of Loan Needed
*
Home Purchase
Refinance
Debt Consolidation
Home Improvement
HELOC(Home Equity Line of Credit)
Other
If other, please specify below:
Applicant Information
Name
*
Mr.
Mrs.
Ms.
First Name
Middle Name
Last Name
Suffix
Birth Date
*
-
Month
-
Day
Year
Date
Are you a US Citizen?
*
Yes
No
Marital Status
*
UnMarried
Married
Separated
Social Security Number
*
Phone Number
*
-
Area Code
Phone Number
Best time to contact you
*
Best time to contact you
*
Morning
Afternoon
Evening
Email
*
example@example.com
Home Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Time at Residence
Years
Months
If you have lived at your current address less than 2 years, please provide the following:
Previous Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Are you a current customer with us?
*
Yes
No
If not, how did you hear about us?
Internet/Web
Newspaper
Friend/Relative
Radio
Other
How are you submitting this loan?
*
Individually
Jointly
Estimated Credit Score
*
Have you ever had a loan the same or similar to what you are applying for?
*
Employment Information
Current Employer
*
Job Title
*
Work Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Work Phone Number
*
-
Area Code
Phone Number
Annual Net Income
*
in USD
Length of Employment
*
Previous Employer (if less than 2 years at current)
Previous Job Title
Previous Work Phone Number
-
Area Code
Phone Number
Co-Applicant Information
Full Name
Mr.
Mrs.
Prefix
First Name
Middle Name
Last Name
Suffix
Current Employer
Job Title
Work Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Work Phone Number
-
Area Code
Phone Number
Annual Gross Income
Who do you currently bank with?
*
What do you estimate your current credit score to be?
*
Date of Birth
*
Social Security Number
*
Length of Employment
Years
Months
Previous Employer (if less than 2 years at current)
Previous Job Title
Previous Work Phone Number
-
Area Code
Phone Number
Previous Length of Employment
Housing Information
Do you currently rent or own your home?
*
Monthly Mortgage/Rent
*
Home Purchase Information
If home purchase, what is your new property address?
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
County
Asking Price
Down Payment
Have you ever filed for Bankruptcy?
*
Yes
No
If yes, what is the year of discharge?
If mortgage refinance, do you currently have any home equity loans?
Yes
No
N/A
If yes, what is the balance?
Estimated property value:
Amount applying for:
Additional Comments
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 loan is approved. You are authorized to check my credit and employment history and to answer questions about your credit experience with me.
*
Applicant's Signature
Submit
Should be Empty: