Close OLB

Online Banking

hand with car keys stand by car

Consumer Credit Application

CONSUMER CREDIT APPLICATION

IMPORTANT APPLICATION 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 and federal law.

Type of Credit Required* Indicates Required Field

Select appropriate boxes below and complete the applicable section.

Type of Credit *
Individual Joint *

Branch and Officer


Ackley Branch - Jessica Schipper
Belmond Branch - Melanie Sopher
Belmond Branch - Pat Fisher
Eldora Branch -  Karisa Cross

Grundy Center Branch - Steph Kiewiet
Iowa Falls Branch - Katie Carpenter
Iowa Falls Branch - Jean Jungling
Iowa Falls Branch - Alyce Johnson

Section A - Individual Applicant Information


Do You

If you have been at your current place of employment less than 2 years, please provide us with your previous employer information below.

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

Alimony, Child Support, separate maintenance received under:
Is any of the above income likely to be reduced during the term of this request?

Section B - Joint Applicant or Other Party Information


Complete only if: for joint credit, for individual credit relying on income or assets from other sources, or applicant is married and resides in a community property state.

Do You

If you have been at your current place of employment less than 2 years, please provide us with your previous employer information below.

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

Joint applicant/other party's Alimony, Child Support, separate maintenance received under:
Is any of the above income likely to be reduced during the term of this request?

Section CB - Marital Status


Applicant *
Other party *

Section DC - Assets & Debit Information


This section should be completed giving information about both the Applicant and Joint Applicant or Other Party. Please mark Applicant-related information with an A.

Assets Owned

Checking Account

Savings Account

Certificate of Deposit

Real Estate

Automobiles (assets)

Other (for assets)


Outstanding Debts

(Include charge accounts, installment contracts, student loans, etc.)

Mortgage Holder

Automobiles (unknown debt)

Other (other debt)

Total Debts

Additional

Complete the following information about both the Applicant and Joint Applicant or Other Party.

Are you obligated to make Alimony, Support, or Maintenance Payments?
Are you obligated to make Alimony, Support, or Maintenance Payments?
Are you obligated to make Alimony, Support, or Maintenance Payments?
Are you a co-maker, endorser, or a guarantor on any loan or contract?
Are you a co-maker, endorser, or a guarantor on any loan or contract?
Are you a co-maker, endorser, or a guarantor on any loan or contract?
Are there any unsatisfied judgments against you?
Are there any unsatisfied judgments against you?
Are there any unsatisfied judgments against you?
Have you been declared bankrupt in the last 10 years?
Have you been declared bankrupt in the last 10 years?
Have you been declared bankrupt in the last 10 years?

Section ED - Secured Credit


Complete only if credit is to be secured. Briefly describe the property to be given as security:

Consumer Credit Insurance Disclosure


This document is a written disclosure for the sale of insurance or annuities when Green Belt Bank & Trust extends credit.

To Credit Applicant: 

Green Belt Bank & Trust advises you that Green Belt Bank & Trust may not condition the extension of credit on the following:

  • Your purchase of an insurance product or annuity from Green Belt Bank & Trust or any of our affiliates;
  • Your agreement not to obtain, or a prohibition on obtaining, an insurance product or annuity from an unaffiliated entity.
 

Insurance and Annuities

  • Are not a deposit account or other obligation of Green Belt Bank & Trust or any affiliate of Green Belt Bank & Trust;
  • Are not guaranteed or insured by Green Belt Bank & Trust;
  • Are not insured by the Federal Deposit Insurance Corporation (FDIC);
  • Are not, except in the case of Federal Flood Insurance or Federal Corp Insurance, insured by any federal government agency;
  • May involve investment risk, including possible loss of value.
 

By submitting, I acknowledge that I receive this disclosure orally and in writing.

There was an error submitting the form
 

Thank you!

Someone will be in touch with you soon.