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Consumer Loan Application

Secure Online Consumer Loan Application
This online consumer loan application was created for your convenience. Please provide all the requesed information. When you have completed the form, press the Submit button to send your application for processing.

The bank will use the information that you provide for the sole purpose of evaluating your loan application. The information will be kept confidential by the bank and will not be provided to any other organization. If you find that you provided us inaccurate information please call us at (406) 642-3431 to correct it.

You only need to fill out this application if you are considering a loan within our lending area of Missoula and Ravalli Counties. We will not accept loan applications out of this lending area.

USA Patriot Act
Important Information About Opening a New Account

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.

PRIVACY NOTICE

Farmers State Bank

PO Box 190 Victor, MT 59875
406-642-3431

FACTS What does Farmers State Bank do with your personal information? Rev. February 2013
Why?

Financial companies choose how they share your personal information.  Federal law gives consumers the right to limit some but not all sharing.  Federal law also requires us to tell you how we collect, share, and protect your personal information.  Please read this notice carefully to understand what we do.

What?

The types of personal information we collect and share depend on the product or service you have with us.  This information can include:

  • Social Security number and income
  • account balances and payment history
  • credit history and credit score

When you are no longer our customer, we continue to share your information as described in this notice.

How? All financial companies need to share customer’s personal information to run their everyday business.  In the section below, we list the reasons financial companies can share their customers’ personal information; the reasons Farmers State Bank chooses to share; and whether you can limit this sharing.
Reasons we can share your personal information Does Farmers State Bank share? Can you limit this sharing?

For our everyday business purposes –

Such as to process your transactions, maintain your account(s), respond to court orders and legal investigations, or report to credit bureaus

Yes No

For our marketing purposes –
To offer our products and services to you

Yes No
For joint marketing with other financial companies No We do not share

For our affiliates’ everyday business purposes –
Information about your transactions and experiences

No We do not share

For our affiliates’ every day business purposes –
Information about your creditworthiness

No We do not share
For nonaffiliates to market to you No We do not share
Questions Call (406) 642-3431 or go to www.farmersebank.com
What we do
How does Farmers State Bank protect my personal information? To protect your personal information from unauthorized access and use, we use security measures that comply with federal law. These measures include computer safeguards and secured files and buildings. We restrict access to nonpublic personal information about you to those employees who need to know that information to provide products or services to you.
How does Farmers State Bank collect my personal information?

We collect your personal information, for example, when you

  • Open an account or Deposit money
  • Pay your bills or Apply for a loan
  • Show your government issued ID

We also collect your personal information from others, such as credit bureaus, affiliates, or other companies.

Why can't I limit all sharing?

Federal law gives you the right to limit only

  • sharing for affiliates' everyday business purposes--information about your creditworthiness
  • affiliates from using your information to market to you
  • sharing for nonaffiliates to market to you

State laws and individual companies may give you additional rights to limit sharing.

Definitions
Affiliates

Companies related by common ownership or control. They can be financial and nonfinancial companies.

-Farmers State Bank has no affiliates.

Nonaffiliates

Companies not related by common ownership or control. They can be financial and nonfinancial companies.

-Farmers State Bank does not share with nonaffiliates so they can market to you.

Joint marketing

A formal agreement between nonaffiliated financial companies that together market financial products or services to you.

-Farmers State Bank does not jointly market.

 *I have read the above Privacy Policy.

*Will there be a co-applicant on this loan application?
Yes No

*Amount requested
*Purpose
*Security
Requested Length of Loan:
Primary Applicant  
*Last Name
*First Name
Middle Name
* Physical Address
*City
*State
*Zip Code
How Long Have You Lived at Current Residence?
How Many Children Do You Have?
Mailing Address
(if different from physical address)
City
State
Zip Code
*Home Phone Number
(Include area code.)
Cell Phone Number
(Include area code.)
Email Address
*Social Security Number
*Date of Birth
*Employer Name
*Employer Phone Number
(Include area code.)
*Job Start Date mo / yr
*Gross Income
* Hourly Monthly Annually
*Job Title
Other Income
(dollar figure)
Monthly Annually
Source of Other Income

Please note: Income verification is required; other information may be required.

Alimony, child support, or separate, maintenance income need not be listed unless you choose to have such income considered regarding extension and repayment of the credit requested.


*Do you own your home? Yes No
Estimated Market Value
 
Joint Applicant (If applicable)
Last Name
First Name
Middle Name
Physical Address
City
State
Zip Code
Mailing Address
(if different from physical address)
City
State
Zip Code
Home Phone Number
(Include area code.)
Cell Phone Number
(Include area code.)
Email Address
Social Security Number
Date of Birth
Employer Name
Employer Phone Number
(Include area code.)
Job Start Date mo / yr
Gross Income
Hourly Monthly Annually
Job Title
Other Income
(dollar figure)
Monthly Annually
Source of Other Income

Please note: Income verification is required; other information may be required.

Alimony, child support, or separate, maintenance income need not be listed unless you choose to have such income considered regarding extension and repayment of the credit requested.


 

Debts / Monthly Payments
Please select the type of payment from the drop-down boxes below and enter the amount of the payment in the field to the right of the box. If you do not find the type of payment that best reflects your particular type of debt in the dropdown box, please use the boxes marked 'Other' to document your information.

Please Note: You must list the amount to the right of each type of payment you select.

Type of Payment Amount

Other (Please specify):


Other (Please specify):


Other (Please specify):

Total

 
*Have you ever filed for bankruptcy?

Yes  No

*Are you paying alimony, child support or maintenance?

Yes 

No

Amount / Month

$

*Are there any claims, suits or judgements against you?

Yes 

No

Amount / Month

$

*Are you a Cosignor, Endorsor or Guarantor for anyone?

Yes 

No

Amount / Month

$

*I / We agree that the bank may use credit reporting agencies or otherwise verify the information on this request.
Yes No

*I / We certify that statements on this application are true and complete.
Yes No

*I / We also acknowledge the disclosure of Federal Sale in Insurance.
Yes No

Purpose
You have submitted an application for a loan. In connection with your loan application, Lender may be soliciting, offering to sell, or will sell you an insurance product or annuity. Federal law requires Lender to provide you with the following disclosures.

Credit Disclosures
1. Lender, as a condition of granting you a loan, cannot require that you purchase an insurance product or annuity from Lender or any of its affiliates.
2. Lender, as a condition of granting you a loan, cannot require your agreement not to obtain or prohibit you from obtaining an insurance product or annuity from an unaffiliated entity.

By submitting the application, I acknowledge that I have read, received and understand the insurance disclosure.


REG B Disclosure

*Are you applying for individual credit in your own name and are you relying on your own income or assets and not the income or assets of another person as the basis for repayment of the credit request?

* Yes No

*Are you applying for individual credit, but are relying on income from alimony, child support, or separate maintenance or on the income or assets o another person as the basis for repayment of the credit requested?

* Yes No

We intend to apply for joint credit.

Applicant
Co-Applicant

Daytime Phone (Include area code.):

Comments: