Automobile Loan Application
Loan Information
Loan Amount: Term: Loan Type: Individual Joint
(If this is an application for joint credit, Borrower and Co-Borrower each agree that we intend to apply for joint credit.)
I/We desire automatic payment from Malvern Bank, National Association checking account number
Automobile Information (for the auto being purchased)
Year Make Model
Applicant (Income verification will be required)
First Name M.I. Last Name
Birth Date Social Security No. Number of dependents, excluding self
Home Street Address
City State Zip
Home Phone (include area code) How long at this address? Yrs. Mos.
Name of current mortgage holder or landlord
Balance owed (if mortgaged) $ Monthly mortgage or rent payment $
Does mortgage payment include taxes & insurance? YesNo If no, list annual amount for taxes & insurance $
Name of business/employer
Business phone (include area code) How long employed there? Yrs. Mos.
Position held Gross monthly salary $ Self-employed Retired
Other income (Applicant & Co-Applicant)
Alimony, child support or separate maintenance need not be revealed if Borrower or Co-Borrower does not choose to have it considered for repaying this loan.
Gross monthly amount $ Name & address of source
Co-Applicant (Income Verification will be required)
First Name M.I. Last Name
Birth Date Social Security No.
Home Street Address (if different from applicant’s)
City State Zip
Home Phone (include area code) How long at this address? Yrs. Mos.
Name of current mortgage holder or landlord
Name of business/employer
Business phone (include area code) How long employed there? Yrs. Mos.
Position held Gross monthly salary $ Self-employed Retired
Customer Certification

Please read the following before signing and submitting your application:

This application is submitted to obtain credit. I/we agree that Malvern Bank, National Association may make inquiries and obtain credit reports to verify information I/we provided. I/we also authorize Malvern Bank, National Association to provide credit and account information to and respond to requests for information from others. If this is a joint application, the applicant and co-applicant shall be jointly and severally liable for any and all credit extended from time to time. The lender or anyone authorized by the lender may obtain or verify any employment, credit or other information relating to my/our application for an automobile loan. The lender may retain this application even if the loan is not granted.

By signing and submitting this application, I/we certify that all information herein is true and correct as of the date submitted and acknowledge my/our understanding that nay intentional or negligent misrepresentation(s) of the information contained in this application may result in civil liability and/or criminal penalties including, but not limited to, fine or imprisonment or both under the provisions of Title 18, United States Code, Section 1001, et seq. and liability for monetary damages to the Lender, its agents, successors and assigns, insurers and any other person who may suffer any loss due to reliance upon any misrepresentation which I/we have made on this application.

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 this information. The information you provide is protected by our privacy policy and federal law.
Applicant Signature Date Co-Applicant Signature Date