Personal Loan Application › First Bank of Manhattan

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Important Applicant Information: 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 the information. The information you provide is protected by our privacy policy found here and federal law.

IMPORTANT INFORMATION IF YOU ARE APPLYING FOR A HOME EQUITY LINE OF CREDIT (HELOC)

Before you apply for a Home Equity Line of Credit (HELOC), please review the required HELOC Application Disclosure and the home equity brochure entitled “What You Should Know About Home Equity Lines of Credit” found here. These disclosures contain important rate, fee, and other cost information about the HELOC product.

*Required Fields

Type of Account Requested *

Joint Account

Individual Account - Relying solely on my income and assets.

Individual Account - Relying on my income and assets as well as the income or assets of another.

Terms Requested

Amount *

No. of Months

Type of Loan *

Purpose of Loan *

Collateral Property

Name of Insurance Carrier

Address of Insurance Carrier

Individual Applicant Information

Name *

Birthdate *

SSN *

Address *

City *

State *

Zip Code *

County *

Previous Address Complete if lived at current address less than 2 years

City

Complete if lived at current address less than 2 years

State

Complete if lived at current address less than 2 years

Zip Code

Complete if lived at current address less than 2 years

County

Complete if lived at current address less than 2 years

Primary Phone *

Business Phone

Email Address *

Own or Rent

How Long?

Monthly Rent/Mortgage Payment

No. of Dependents

Ages of Dependents

Employer

Employer's Address

Position

Years Employed

Gross Monthly Income

Previous Employer Complete only if at current employer less than 2 years.

Previous Employer's Address Complete only if at current employer less than 2 years.

Position Complete only if at current employer less than 2 years.

Years Employed Complete only if at current employer less than 2 years.

Other Income

Alimony, Child Support, or Separate Maintenance Income Received Pursuant to: Note: Alimony, child support, or separate maintenance income need not be revealed if you do not wish to have it considered.

Source

Amount/Month

Marital Status

Joint Applicant or Other Party Information

Provide the information in this section for a joint applicant, another party that will use or contribute assets or income towards repayment on the account, or for your spouse if you live in, or the collateral property is located in AZ, CA, ID, LA, NM, NV, TX, WA, or WI.

Name *

Birthdate *

SSN *

Address *

City *

State *

Zip Code *

County *

Previous Address Complete if lived at current address less than 2 years

City

Complete if lived at current address less than 2 years

State

Complete if lived at current address less than 2 years

Zip Code Complete if lived at current address less than 2 years

County

Complete if lived at current address less than 2 years

Primary Phone *

Business Phone

Email Address *

Own or Rent

How Long?

Monthly Rent/Mortgage Payment

No. of Dependents

Ages of Dependents

Employer

Employer's Address

Position

Years Employed

Gross Monthly Income

Previous Employer

Complete only if at current employer less than 2 years.

Previous Employer's Address

Complete only if at current employer less than 2 years.

Position

Complete only if at current employer less than 2 years.

Years Employed

Complete only if at current employer less than 2 years.

Other Income

Alimony, Child Support, or Separate Maintenance Income Received Pursuant to:

Note: Alimony, child support, or seperate maintenance income need not be revealed if you do not wish to have it considered.

Source

Amount/Month

Marital Status

General Information

Note: If you or a joint applicant or other party answers "yes" to any of the following questions, please explain in the space provided

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

Yes

Are there any suits or judgements against you?

Yes

Have you been declared bankrupt in the last 10 years?

Yes

Joint Applicant General Information

Note: If you or a joint applicant or other party answers "yes" to any of the following questions, please explain in the space provided

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

Yes

Are there any suits or judgements against you?

Yes

Have you been declared bankrupt in the last 10 years?

Yes

Assets

Note: If "Joint Applicant or Other Party Information" section was completed above, this section should be completed giving information about both the Applicant and the Joint Applicant or Other Party.

Checking Accounts

Bank Name

Name(s) on Account

Value

Add Checking Account

Savings Accounts

Bank Name

Name(s) on Account

Value

Add Savings Account

Automobiles

Make

Model

Year

Name(s) on Account

Value

Add Automobile

Retirement Accounts

Bank Name

Name(s) on Account

Value

Add Retirement Account

Other Real Estate

Address

Date Acquired

Name(s) on Account

Value

Add Other Real Estate

Other Assets

Describe

Value

Add Other Asset

Total Assets

Value

Notice

I certify that everything I have stated in this application and on any attachments is correct. You may keep this application whether or not it is approved. By signing below, I authorize you 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 you about my credit record with you. I understand that I must update this credit information at your request and if my financial condition changes. I/We acknowledge by typing my/our name(s) in the Applicant Signature box below I/We hereby apply for the loan or credit described in this application.

Applicant Signature *

Date

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