Home Equity Loan Application

IMPORTANT APPLICANT INFORMATION:  Federal law requires financial institutions to obtain sufficient information to verify your identity.  You may be asked several questions and to provide one or more forms of identification to fulfill this requirement.  In some instances we may use outside sources to confirm the information.  The information you provide is protected by our privacy policy and federal law.

Type of Account Requested

Check one to indicate the type of account you are requesting. Note: Married applicants may apply for separate accounts.
Joint Account Individual Account - Relying solely on my income and assets
Individual Account - Relying on my income and assets and as well as income or assets of another

Terms Requested

Amount: $ Interest Rate: Type of loan: Fixed Rate ARM (type): Line of Credit:
No of Months: Payment: $ / Purpose: Home Improvement Pay Debt:    Other:

Collateral Property

Address: Date purchased: Year Built: Present Value: $ Balance Owing: $
Title in Name(s) of: Address of Title Holder: Name and Address
of Insurance Carrier:
   
Mortgage Holder
Name: Address: Phone No: Acct. No:

Individual Applicant Information

Name: Birth date: Social Security No:
Address
(Street, City, State, Zip):
County: Drivers License No:
Home Phone: Business Phone: Cell Phone:    
Email Address: No of Dependents: Ages of Dependents:
Employer/Self Employed: Position: Years Employed: Employer's Address:
Wages, Salary, Commissions   Gross $ / month: Net $ / month: How Often Paid:
Previous Employer: Position: Years Employed: Employer's Address:
Name and Address of
Applicant's Nearest Relative:
Relationship:
Alimony, child support, or separate maintenance income need not be revealed if you do not with to have it considered.  Alimony, child support, separate maintenance received pursuant to:  Court Order Written Agreement Oral Understanding
Other Income: Source Amount/Month:
Marital Status: Married Separated Unmarried (includes single, divorced and widowed)

Joint Applicant or Other Party Information

Name: Birth date: Social Security No:
Address
(Street, City, State, Zip):
County: Drivers License No:
Home Phone: Business Phone: Cell Phone:    
Email Address: No of Dependents: Ages of Dependents:
Employer/Self Employed: Position: Years Employed: Employer's Address:
Wages, Salary, Commissions   Gross $ / month: Net $ / month: How Often Paid:
Previous Employer: Position: Years Employed: Employer's Address:
Joint Applicant’s or Other
Party’s Nearest Relative
Relationship:
Alimony, child support, or separate maintenance income need not be revealed if you do not with to have it considered.  Alimony, child support, separate maintenance received pursuant to:  Court Order Written Agreement Oral Understanding
Other Income: Source Amount/Month:
Marital Status: Married Separated Unmarried (includes single, divorced and widowed)

General Information

If you or a joint applicant or other party answers "yes" to any of the following questions, please explain in the space provided.
Are you a guarantor or co-maker of any leases, contracts or debts? Applicant: Yes No Joint Applicant/Other Party: Yes No
Are there any suits or judgments pending against you? Applicant: Yes No Joint Applicant/Other Party: Yes No
(include amount)
Have you been declared bankrupt in the last 10 years? Applicant: Yes No Joint Applicant/Other Party: Yes No

Previous Credit References

Describe any previous debt obligations. Please mark Applicant-related information with an "A".
1. $ Date Paid
2. $ Date Paid

Asset Information

If "Joint Applicant or Other Party Information" section was completed above, this section should be completed giving information about both Applicant and the Joint Applicant or Other Party.
Assets
Description of Current Assets Names of Owner(s) Subject to Debt: Yes/No Value
Checking Accounts (Institution, Acct. No.)     $
Savings Accounts (Institution, Acct. No.)
Automobiles (Make, Model, Year)
Marketable Securities (Issuer, Type, No. of Shares)
Life Insurance Cash Value (Issuer)
Other Real Estate (Location, When Acquired)      
Other Assets (Describe)
Total Assets    
 

Debt Information

Include all charge accounts, installment contracts, credit cards, rents, mortgages and other obligations.

Creditor Account
Number
Names in Which the
Account is Carried
Original
Amount
Present
Balance
Monthly
Payments
Landlord or Mortgage Holder on other Real Estate
Auto Loans          
Credit or Charge Cards
 
Total Debts    

Married Wisconsin Residents:
No provision of any material property agreement unilateral statement under Wisc. Statutes §766.59 or a court decree under Wisc. Statutes § 766.70 adversely affects the interest of the lender unless the lender, prior to the time the credit is granted, is furnished a copy of the agreement, statement or decree or has actual knowledge of the adverse provision when the obligation to the lender is incurred.

Important Disclosure for Home Equity Loan Application

I agree that I have read and agree to the following product Disclosures, Agreements, and Terms & Conditions:

I Agree Electronic Disclosure | Home Equity Lines of Credit booklet

Notice - Joint Credit

We intend to apply for joint credit. (initials)

I certify that everything I have stated in this application and on any attachments is correct.  Lender may keep this application whether or not it is approved.  By signing below, I authorize Lender to check my credit and employment history, to have a consumer credit report prepared on me for the purpose of evaluating this application for credit, and to answer questions others may ask Lender about my credit record with Lender.  I understand that I must update this credit information at Lender's request and if my financial condition changes

Applicant Date Joint Applicant Date
 
 

Creditor Use Only

This application was taken by: face-to-face interview mail telephone internet
Date Application Received: Received By: Amount Requested: $
Date Application Completed: Approved By: Amount Approved: $
Rescindable:
Yes No
RESPA Applicable
Yes No
  Funding Date: Initial Advance: $