Loan Application

Applications sent outside of regularly scheduled hours, on weekends or on holidays in which Dakota Western Bank is not open, are considered received on the next business day.

For real estate loans, please contact the branches directly for an application.

To help the government fight the funding of terrorism and money laundering activities, the USA Patriot Act 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, physical address, date of birth, and tax payer identification number (Social Security #) and other information that will allow us to identify you. We may also ask to see your driver's license or other identifying documents. We will let you know if additional information is required.

Loan Information

Are you applying as an individual or with a co-applicant?
Will the loan proceeds be used towards a hemp related business or product? This includes but is not limited to: general retail sales of CDB Oil, Dispensary Sales of CBD oil, Pharmacy Sale of CBD oil, Online sales of CBD oil and Hemp producers of fibers, textiles, seed, meal, oil, imports or exports.
Will the loan proceeds be used towards a marijuana related business or product? This includes but is not limited to: adult or medical use, retail, processing, cultivation, testing, operations that support marjiuana businesses, landlords of a marijuana business, etc.

Primary Applicant

Is your present address your permanent address?
How long have you been at your present address?
Marital Status

Employment/Income Information of Primary Applicant

Full Time
NOTICE: 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 the obligation.
Is your alimony, child support, or separate maintenance income received under

Joint Applicant

Is your present address your permanent address?
How long have you been at your present address?
Marital Status

Employment/Income Information of Joint Applicant

Full Time
NOTICE: 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 the obligation.
Is your alimony, child support, or separate maintenance income received under

Financial Information

Do you have a checking account?
Do you have a savings account?

Active Duty

Assets Owned

Do you own any assets?
Subject to Debt

Outstanding Debt

Do you have any outstanding debt?
Past Due

Housing Debt

Do you have any housing debt (Rent or Mortgage)?
Rent or Mortgage Payment

Additional

I have additional questions or requests

We will contact you upon receiving your application to schedule a time that is convenient to finish loan processing procedures.

Which branch would you like to come into for your loan interview?

Endorsement

The purpose of this questionnaire is to begin the application process. All applications are subject to approval and will be contacted to schedule a time that is convenient to finish loan procedures.

I certify that everything 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. By signing below, I authorize you to check my credit and employment history and to answer any questions about your credit experience with me.

By entering my name below, I hereby give the electronic equivalent of my signature.

Endorsement

The purpose of this questionnaire is to begin the application process. All applications are subject to approval and will be contacted to schedule a time that is convenient to finish loan procedures.

I certify that everything 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. By signing below, I authorize you to check my credit and employment history and to answer any questions about your credit experience with me.

By entering my name below, I hereby give the electronic equivalent of my signature.