Loan Application

Apply for a loan from TruPoint

Required Information

Select TruPoint Bank Branch Location

Select Loan Type:

Personal Loan/ Line of Credit
Vehicle Loan
Home Equity Loan
Home Equity Line of Credit

Purpose of Loan: Requested Loan Amount (Note: $3,000 Minimum): Collateral Information:

We intend to apply for joint credit:

Joint Credit

You are applying for joint credit. This means you are applying for credit with another person and will be relying on both your and their income or assets as the basis for repayment. Complete both the applicant information and the co-applicant information.

Individual Credit

You are applying for individual credit. This means you are applying in your own name and are relying on you own income or assets, NOT those of another person as the basis for repayment. Complete only the applicant information

Loan Information

What type of vehicle is this loan for:

New
Used

Automobile
Boat
Truck
Camper
Other

Other: Vehicle Year: Vehicle Make: Vehicle Model: Vehicle Mileage: You've indicated this is a truck. Please provide G V W: You've indicated this is a boat. Please provide type and length: # of Cylinders or Engines: Serial or VIN Number:

Equipped With:

Engine Size (in cu): Engine Horsepower: Cash Price: Cash Down Payment: Trade-In Allowance Amount to be Financed: Dealer or Seller's Name: Dealer or Seller's Address: City: State: Zip Code: Insurance Agent Address: City: State: Zip Code:

Applicant Information

First Name: Middle Name: Last Name: Home Phone: Social Security Number: Date of Birth: Driver's License Number: State: DL Issued: DL Expired: EMail Address: Address: Physical Address: City: State: Zip: Years There:

If length of time at current address is less than two years, please complete this section Previous Address: City: State: Zip: Years There:

Housing:

Own
Rent

Rent/Mortgage per Month: Name of Mortgage Holder/Landlord: Mortgage Holder/Landlord Address: City: State: Zip Code: Original Amount of Mortgage: Present Balance: Present Value: Checking Acc #: Institution or Branch: Savings Acc #: Institution or Branch: Name of Nearest Relative: Relative's Street Address: City: State: Zip Code: Relationship: Phone:

Applicant Income Information

Present Employer: Position or Title: Work Telephone: Type of Work: Address: City: State: Zip Code: Name of Supervisor: Years With company: Annual Gross Salary: Previous Employer: Years with company: Address: City: State: Zip: # of Dependents: Ages of Dependents:

Alimony, child support, or separate maintenance income need not be revealed if you do not wish to have it considered as a basis for repaying this obligation.

Other Income Amount:

Other Income

Weekly
Monthly
Yearly

Source of Other Income

Do you presently pay

Type	Amount	Weekly	Monthly
Alimony	Amount	Weekly	Monthly
Support	Amount	Weekly	Monthly
Maintenance	Amount	Weekly	Monthly

General Information

If you answer "yes" to any of the following questions, please explain in the space provided.

Are you a guarantor or co-maker of any leases, contract or debts?

Explain

Are there any suits or judgements against you? (Include amount)

Explain

Have you been declared bankrupt in the last 10 years?

Have you had property foreclosed upon or given title or deed in lieu thereof in the last 7 years?

Explain

Co-Applicant Information

If length of time at current address is less than two years, please complete this section Previous Address: City: State: Zip: Years There:

Co-Applicant Income Information

Present Employer: Position or Title: Work Telephone: Type of Work: Address: City: State: Zip Code: Name of Supervisor: Years With company: Annual Gross Salary: Relationship to Applicant: # of Dependents: Ages of Dependents:

Alimony, child support, or separate maintenance income need not be revealed if you do not wish to have it considered as a basis for repaying this obligation.

Other Income Amount:

Other Income

Weekly
Monthly
Yearly

Source of Other Income

Do you presently pay

Type	Amount	Weekly	Monthly
Alimony	Amount	Weekly	Monthly
Support	Amount	Weekly	Monthly
Maintenance	Amount	Weekly	Monthly

General Information

If you answer "yes" to any of the following questions, please explain in the space provided.

Are you a guarantor or co-maker of any leases, contract or debts?

Explain

Are there any suits or judgements against you? (Include amount)

Explain

Have you been declared bankrupt in the last 10 years?

Explain

Current Debts

List all debts to banks, loan or finance companies, charge accounts, and installment purchases. Include debts on which applicant is a co-maker, endorser, or guarantor.

Debt

Name of Creditor Account Type Original Amount Balance Due Monthly Payment

 Add Another Debt

Automobile Insurance is required for the full term of the contract, at your expense against the hazards of fire, theft and accidental physical damage (Including collision). The policy is to note the bank's interest with a loss payable clause in its favor. You may choose the person through whom any insurance is obtained.

Demographic Information Addendum

This section asks about your ethnicity, sex, and race.

Demographic Information of Borrower

The purpose of collecting this information is to help ensure that all applicants are treated fairly and that the housing needs of communities and neighborhoods are being fulfilled. For residential mortgage lending, Federal law requires that we ask applicants for their demographic information (ethnicity, sex, and race) in order to monitor our compliance with equal credit opportunity, fair housing, and home mortgage disclosure laws. You are not required to provide this information, but are encouraged to do so. You may select one or more designations for "Ethnicity" and one or more designations for "Race." The law provides that we may not discriminate on the basis of this information, or on whether you choose to provide it. However, if you choose not to provide the information and you have made this application in person, Federal regulations require us to note your ethnicity, sex, and race on the basis of visual observation or surname. The law also provides that we may not discriminate on the basis of age or marital status information you provide in this application. If you do not wish to provide some or all of this information, please check below.

Ethnicity: Check one or more Hispanic or Latino

Mexican
Puerto Rican
Cuban
Other Hispanic or Latino

Print origin: Not Hispanic Latino I do not wish to provide this information

Sex

Female
Male
I do not wish to provide this information

Race: Check one or more American Indian or Alaska Native Print name of enrolled or principal tribe: Asian

Asian Indian
Chinese
Filipino
Japanese
Korean
Vietnamese
Other Asian

Print race: (For example: Hmong, Laotian, Thai, Pakistani, Cambodian, and so on.) Black or African American Native Hawaiian or Other Pacific Islander

Native Hawaiian
Guamanian or Chamorro
Samoan
Other Pacific Islander

Print race: (For example: Fijian, Tongan, and so on.) White I do not wish to provide this information

Co-Borrower Demographic Information Addendum

This section asks about your ethnicity, sex, and race.

Demographic Information of Co-Borrower

Ethnicity: Check one or more Hispanic or Latino

Mexican
Puerto Rican
Cuban
Other Hispanic or Latino

Print origin: Not Hispanic Latino I do not wish to provide this information

Sex

Female
Male
I do not wish to provide this information

Race: Check one or more American Indian or Alaska Native Print name of enrolled or principal tribe: Asian

Asian Indian
Chinese
Filipino
Japanese
Korean
Vietnamese
Other Asian

Print race: (For example: Hmong, Laotian, Thai, Pakistani, Cambodian, and so on.) Black or African American Native Hawaiian or Other Pacific Islander

Native Hawaiian
Guamanian or Chamorro
Samoan
Other Pacific Islander

Print race: (For example: Fijian, Tongan, and so on.) White I do not wish to provide this information

Authorization & Signatures

If you would like to receive confirmation and notification of your application status, please indicate below. We will use the email address you supplied in the application above. (You will still receive some communication via US Mail.) You will receive confirmation of your application within one business day.

I certify that everything I have stated in this application and on any attachments is correct. TruPoint Bank may keep this application whether or not it is approved. By typing and submitting this form, I authorize TruPoint Bank 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 TruPoint Bank about my credit record with TruPoint Bank. I understand that I must update this credit information at TruPoint Bank's request and if my financial condition changes.

Yes, I agree to the terms of the Home Equity Application Disclosure. Yes, I have read the HELOC Brochure.

Applicant Signature Date Co-Applicant Signature Date