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Bank of Gravette Consumer Loan Application

Please complete all sections to get the quickest decision possible.






Amount Requested*
Term Requested*
Type of Collateral Being Offered





VIN or Serial Number (if applicable)
Purchase Price/Value
How will you use the funds?
APPLICANT
Applicant Full Name* (First/Middle/Last)
Jr/Sr
Mailing Address*
City*
State*
Zip*
Street Address*
How long?
City*
State*
Zip*



Former Address (if less than 2 years)
How Long?
Social Security Number*
Date of Birth*
Home Phone*
Cell Phone
Email Address*
Confirm Email*
Name of Nearest Relative* (Not Living with You)
Relationship*
Relative's Address*
Phone Number*
CO-APPLICANT
Co-Applicant Full Name* (First/Middle/Last)
Jr/Sr
Mailing Address*
City*
State*
Zip*
Street Address*
How long?
City*
State*
Zip*



Former Address (if less than 2 years)
How Long?
Social Security Number*
Date of Birth*
Home Phone*
Cell Phone
Email Address*
Confirm Email*
Name of Nearest Relative* (Not Living with You)
Relationship*
Relative's Address*
Phone Number*
APPLICANT OCCUPATION
Employer
Employer Address
Employer Phone
Length of Employment
Position
Previous Employment / Position
How Long?
CO-APPLICANT OCCUPATION
Employer
Employer Address
Employer Phone
Length of Employment
Position
Previous Employment / Position
How Long?
INCOME

List sources of income below. Income received from child support, alimony or maintenance is optional information furnished only if you desire this income to be considered in our credit decision.

APPLICANT INCOME
Gross Monthly Salary*
Rental Income
Other: Bonus, Dividends, Etc.
TOTAL
CO-APPLICANT INCOME
Gross Monthly Salary*
Rental Income
Other: Bonus, Dividends, Etc.
TOTAL

Though purchase is not required, Credit Life and Disability Insurance may be a valuable product for people who do not have standard life insurance or enough life insurance to cover debts and expenses. This product is offered to all applicants with very few restrictions and at a reasonable cost.

INSURANCE DISCLOSURE FOR CREDIT APPLICATION

We are soliciting, offering or selling an insurance product or annuity in connection with this extension of credit. FEDERAL LAW PROHIBITS US FROM CONDITIONING THE EXTENSION OF CREDIT ON EITHER:

  • Your purchase of an insurance product or annuity from us or from any of our affiliates; or
  • Your agreement not to obtain, or a prohibition on you from obtaining, an insurance product or annuity from an unaffiliated entity.
REAL ESTATE OWNED

Please list all real estate owned. Please indicate how the property title is held: (A) Applicant; (C) Co-Applicant; (J) Joint

Property 1
A,C,J
Description/Address
Purchase Date
Lien Holder
Value
Loan Balance
Monthly Payment
Rental Income
Property 2
A,C,J
Description/Address
Purchase Date
Lien Holder
Value
Loan Balance
Monthly Payment
Rental Income
Property 3
A,C,J
Description/Address
Purchase Date
Lien Holder
Value
Loan Balance
Monthly Payment
Rental Income
Property 4
A,C,J
Description/Address
Purchase Date
Lien Holder
Value
Loan Balance
Monthly Payment
Rental Income
FINANCIAL STATEMENT
ASSETS
Checking Account
A,C,J
Institution Name
Current Value
Savings Account
A,C,J
Institution Name
Current Value
Marketable Securities
(i.e. Stocks, Bonds)
A,C,J
Current Value
Value of Primary Residence
A,C,J
Current Value
Value of Other Real Estate
A,C,J
Current Value
Auto #1
A,C,J
Make / Model
Current Value
Auto #2
A,C,J
Make / Model
Current Value
Boat / RV
A,C,J
Make / Model
Current Value
Personal Property
A,C,J
Current Value
Retirement / Profit Sharing
A,C,J
Current Value
Other Assets
A,C,J
Please Describe
Current Value
Other Assets
A,C,J
Please Describe
Current Value
Other Assets
A,C,J
Please Describe
Current Value
Other Assets
A,C,J
Please Describe
Current Value
Other Assets
A,C,J
Please Describe
Current Value
Other Assets
A,C,J
Please Describe
Current Value
TOTAL ASSETS
DEBTS OUTSTANDING
Rent or Mortgage Payment
A,C,J
Loan Balance
Monthly Payment
Other Real Estate Debt
A,C,J
Loan Balance
Monthly Payment
Credit Card
A,C,J
Loan Balance
Monthly Payment
Credit Card
A,C,J
Loan Balance
Monthly Payment
Credit Card
A,C,J
Loan Balance
Monthly Payment
Credit Card
A,C,J
Loan Balance
Monthly Payment
Credit Card
A,C,J
Loan Balance
Monthly Payment
Credit Card
A,C,J
Loan Balance
Monthly Payment
Auto Loan
A,C,J
Loan Balance
Monthly Payment
Auto Loan
A,C,J
Loan Balance
Monthly Payment
Boat Loan
A,C,J
Loan Balance
Monthly Payment
Other Debt
A,C,J
Loan Balance
Monthly Payment
Other Debt
A,C,J
Loan Balance
Monthly Payment
Other Debt
A,C,J
Loan Balance
Monthly Payment
Other Debt
A,C,J
Loan Balance
Monthly Payment
Other Debt
A,C,J
Loan Balance
Monthly Payment
TOTAL DEBTS (Loan Balance)
TOTAL DEBTS (Monthly Payments)
ADDITIONAL QUESTIONS

If you answer "yes" to any of these questions, please explain in the comments section.

Are you a guarantor on any other loan?*



Are you a defendant in a legal action or suit?*



Have you ever declared bankruptcy?*



Comments
Intent of Application - Please check appropriate box and all applicants MUST sign below

Applicant Signature*
Co-Applicant Signature*

I (We) make application to Bank of Gravette for a consumer loan. Everything I (we) have stated in this application is correct to the best of my (our) knowledge. I (We) understand that you will retain this application whether or not it is approved. You are authorized to check my (our) credit and employment history and to answer questions about your credit experience with me (us). I (We) understand that upon approval of this loan application, additional personal and financial information as well as information regarding any collateral offered may be required prior to disbursement of loan proceeds, and that I am (we are) responsible for any third party costs that may be incurred in the processing of the credit request.

Applicant Signature*
Date
Co-Applicant Signature*
Date
*Required Fields