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Home Equity Application

HOME EQUITY 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 Requested Account* Indicates Required Field


Please Select: *

Branch, Officer, and NMLS Information


Institution ID: 446252

Ackley Branch - Jessica Schipper - NMLS #1671274
Belmond Branch - Melanie Sopher - NMLS #1495203
Eldora Branch - Karisa Cross - NMLS# 1843887
Grundy Center Branch - Stephanie Kiewiet - NMLS #1032523

Iowa Falls Branch - Katie Carpenter - NMLS #1792267
Iowa Falls Branch - Jean Jungling - NMLS #480316
Iowa Falls Branch- Alyce Johnson - NMLS #1817340

Terms Requested


Collateral/Property Information


Property Type

Borrower Information


Marital Status *
Former Address Type

Borrower Employment Information


If employed with current employer for less than two years, or if currently employed with more than one job, complete the following:

Co-Borrower Information


Co-Borrower Marital Status *
Former Address Type

Co-Borrower Employment Information


If employed with current employer for less than two years, or if currently employed with more than one job, complete the following:

Income


Gross Monthly Income

Borrower

Co-Borrower

Total

Describe Other Income

Monthly Amount

Base Income

Overtime/Bonus

Other Income

TOTAL

References


Insurance


Insurance Company for Collateral Property

Assets & Liabilities


Deposits and Investment Accounts


Real Estate Owned


Automobiles and Personal Property


Unsecured Liabilities

Paying with this loan
Paying with this loan
Paying with this loan
Paying with this loan
Are you obligated to pay alimony/child support or separate maintenance?

Additional

Are you a guarantor or co-maker of any leases, contracts, or debts? *
Are there any suits or judgments pending against you? *
Have you been declared bankrupt in the last 10 years? *

I certify that everything I have stated in this application and on any attachment is correct. Lender may keep this application whether or not it is approved. By submitting below I authorize Lender to check my credit and employment history and to answer questions others may ask Lender about my credit record with Lender. I understand that I must update this credit information at Lender's request and if my financial condition changes.

HELOC Brochure   HELOC Disclosures

By submitting this, I acknowledge receipt of the Home Equity Brochure and the Lender's Home Equity disclosure statement on today's date.

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