Auto/Personal Loan Application

* Required Field

Loan Information

Purpose *
Amount Requested *
Branch *
Detailed Description of or Reason for Personal Loan
Year
Make
Model
VIN/SN
Mileage
(put n/a if not applicable)

Personal Information

First Name *
MI
Last Name *
Social Security Number *
Street Address *
City *
State *
Zip Code *
Telephone Number *
Birthdate (Month/Day/Year) *
E-mail Address
Citizenship*

Housing Information

Length of Residence *
 years  months
Housing Status *
Monthly Payment *
*If length of residence is less than two years, please provide previous address.
Previous Street Address
Previous City
Previous State
Previous Zip
Mortgage Holder
Estimated Property Value
Mortgage Balance

Employment Information

Employer*
Telephone Number
Supervisor
Street Address
City
State
Zip Code
Position/Department
Length of Employment*
 years  months
Income*
Per
*If length of employment is less than two years, please provide Previous Employer and Previous Length of Employment.
Previous Employer
Previous Length of Employment
 years  months

Financial Information

Do you have a Checking Account?
 Yes  No
Checking Account Number
Financial Institution
Do you have a Savings Account?
Yes No
Savings Account Number
Financial Institution

References

Name of a Relative
Relationship to Applicant
Telephone Number
Street Address
City
State
Zip Code
Name of a Personal Friend
Telephone Number
Street Address
City
State
Zip Code
I acknowledge that I have received this disclosure on today’s date.


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Submission of this form authorizes SpiritBank to verify the information provided herein
including, but not limited to, employment and credit history.

*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.