Auto / Personal Loan Application

Required Field

Document Preparation Fee - $75 at closing, other fees may also apply.

Loan Information

Is this a personal or auto loan?

Are you applying as an individual or jointly?

Please indicate by your initials if you intend to apply jointly.

Vehicle Loan Information

Applicant

How would you prefer to be contacted?

Housing Status

Applicant Employment

Have you worked here for more than three years? (No if unemployed)

Previous Employer (if less than three years at current)

Income Information

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

Financial Information

Do you have a checking account?

Do you have a savings account?

Co-Applicant

How would you prefer to be contacted?

Housing Status

Applicant Employment

Have you worked here for more than three years? (No if unemployed)

Previous Employer (if less than three years at current)

Income Information

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

Financial Information

Do you have a checking account?

Do you have a savings account?

Credit Reference

List all debts, including second mortgage. Provide additional documentation if needed.

Lender

Add Another Lender

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?

Do you expect any disruptions or decreases in income during the term of this loan?

Automatic Loan Payment

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

Automatically transferred funds will be applied as my monthly payment on each monthly due date so long as there are adequate funds on deposit or there is available credit in my account, until the loan is paid or the Bank receives written notice to cancel. I understand the Bank reserves the right to terminate the automatic repayment plan without notice.

Loan Payment Date

Endorsement

I certify that all information provided by me herein, including attachments (s) is true, correct and complete. I authorize Independence 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 Independence Bank to provide credit information about its credit experience with me to other creditors and credit reporting agencies. I understand that this application will be kept whether or not it is approved. I agree to provide any further information the Bank might require to process my application.