Auto / Personal Loan Application

Required Field

Loan Information

Is there a First Security Bank lender assisting you with this application?

Select Lender

Is this a personal or auto loan?

Auto Loan
Personal Loan

Loan Term Amount Requested

Are you applying as an individual or with a co-applicant?

Individual
Co-Applicant

Vehicle Loan Information

Auto Purchase Type

New
Used

Year Make Model VIN or Serial Number Mileage

Applicant

First Name Middle Initial Last Name Suffix Social Security Number Birth Date Home Address City State Zip Code Primary Phone Number Work Phone Number E-mail Address

How would you prefer to be contacted?

Primary Phone
Work Phone
Email
Other

Applicant Employment

Employed
Not Employed

Employment Start Date Position or Title Gross Monthly Income Name of Employer Employer's Address City State Zip Code Employer's Phone Number

Have you worked here for more than 2 years?

Previous Employer (if less than two years at current)

Employment Start Date Position or Title Gross Monthly Income Name of Employer Employer's Address City State Zip Code Employer's Phone Number

Income Information

Number of Dependents

Do you intend to rely on the co-applicant's earnings to qualify for this loan?

Other Monthly Income Income Source

Note: Alimony, Child Support or Separate Maintenance Incomes do not have to be revealed unless you wish to have them considered in loan qualification.

Co-Applicant

Co-Applicant Information

First Name Middle Initial Last Name Suffix Social Security Number Birth Date Home Address City State Zip Code Primary Phone Number Work Phone Number E-mail Address

How would you prefer to be contacted?

Primary Phone
Work Phone
Email
Other

Co-Applicant Employment

Employed
Not Employed

Employment Start Date Position or Title Gross Monthly Income Name of Employer Employer's Address City State Zip Code Employer's Phone Number

Have you worked here for more than 2 years?

Previous Employer (if less than two years at current)

Employment Start Date Position or Title Gross Monthly Income Name of Employer Employer's Address City State Zip Code Employer's Phone Number

Income Information

Number of Dependents

Do you intend to rely on the applicant's earnings to qualify for this loan?

Other Monthly Income Income Source

Note: Alimony, Child Support or Separate Maintenance Incomes do not have to be revealed unless you wish to have them considered in loan qualification.

Credit Information

Have you or your co-applicant ever declared bankruptcy?

Have you or your co-applicant ever had a judgment?

Have you or your co-applicant ever had a repossession or foreclosure?

If yes to any of the above, please explain.

Automatic Loan Payment

Do you want your monthly payment automatically deducted from your First Security Bank checking or savings account?

Please initial your request

Endorsement

I certify that all information provided by me herein, including attachments (s) is true, correct and complete. I authorize First Security Bank to make whatever inquiries about me you deem necessary and appropriate for the purpose of evaluating my credit, including obtaining credit reports and contacting my employer. I also authorize First Security Bank to provide credit information about its credit experience with me to other creditors and credit reporting agencies. I authorize the Bank to obtain address information from the Department of Motor Vehicles and waive the address confidentiality requirements of the State Vehicle Code. I agree to provide any further information the Bank might require to process my application.

Applicant's Signature Date Co-Applicant's Signature Date