THIS IS A LOAN INQUIRY ONLY AND A FULL CREDIT APPLICATION WILL BE REQUIRED.
A loan officer will contact you as soon as possible.
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*Please Note: Alimony, child support, or maintenance income need not be revealed if you do not wish it to be
considered as a basis for repaying this obligation.
SUBMISSION OF THIS FORM AUTHORIZES FARMERS & MERCHANTS BANK & TRUST TO VERIFY INFORMATION PROVIDED HEREIN, INLCUDING BUT NOT LIMITED TO EMPLOYMENT AND CREDIT HISTORY.