Do You :
Live with relatives .................... Monthly Payment $
Mortgage Holder or Landlord
Market Value of Home $
Mortgage Balance $
Are you obligated to pay child support or alimony?
No ....... If Yes, How much $
When does this obligation end?
all other debts including vehicle loans, leases, all credit
card accounts, installment loans, student loans, home equity loans,
NOTICE TO MARRIED APPLICANTS: No provision of any marital property agreement, unilateral statement
under s766.59, Wis. Stats. or court decree under s766.70 adversely
affects the interest of the creditor unless the creditor, prior
to the time the credit is granted or and open-end credit plan
is entered into, is furnished a copy of the agreement, statement
or decree or has actual knowledge of the adverse provision.
NOTICE OF RIGHT TO RECEIVE COPY OF APPRAISAL: Under the
Federal Equal Opportunity Act, if the credit being applied for
will be secured by a 1-4 family dwelling, you have the right to
a copy of the appraisal report used in connection with your
application. If a coy was not already provided to you and you
wish a copy, please write to the creditor at the address on the
face page of this application. Be sure to include your name and
address. The creditor must hear from you no later than ninety
(90) days after it notifies you about the action taken on your
application or you withdraw your application. In order to
receive a copy of the appraisal report, you must also have paid
for the appraisal and the costs of photocopying the report.
the purpose of obtaining the credit described above, and any future
credit granted to the undersigned by the creditor named above,
the undersigned, jointly and severally, (1) represent that the above
statements are true and complete, (2) authorize the creditor named
above, or it's agents, to verify them and obtain additional information
concerning our credit, employment history or any other
information, including credit reports (althought creditor may
rely on these statements without any further verification), to furnish
such information and any other credit experience with me to
others, and to answer any questions about our credit experience
and other financial relationships with the creditor, and (3) agree to the provisions of any rules, regulations or agreements
of the creditor named above governing such credit. This application
is creditor's property. The creditor may share information
bearing on my credit worthiness, credit standing, credit
capacity, character, general reputation, personal
characteristics or mode of living with its affiliates unless I
direct the creditor at the address above that such information
if unrelated to my transactions or experiences with the creditor
may not be shared by the creditor with its affiliates.
NOTICE: REPORTING NEGATIVE INFORMATION TO CREDIT BUREAUS
- We may report information about your account to credit
bureaus. Late payments, missed payments, or other defaults on
your account may be reflected in your credit report.
The undersigned understand that it may
be a federal crime punishable by fine or imprisonment or both
to knowingly make any false statements concerning any of the above
facts, under the provision of Title 18, United States Code, Section
IMPORTANT INFORMATION ABOUT PROCEDURES FOR OBTAINING CREDIT
To help the government fight the funding of terrorism and money
laundering activities, Federal law requires all financial
institutions to obtain, verify, and record information that
identifies each person who obtains credit.
What this means for you: when you obtain credit, we will ask for
your name, address, date of birth, and other information that
will allow us to identify you. We may also ask to see your
driver's license or other identifying information.
CO-Applicant Spouse Name:
Married Wisconsin Resident:
The credit being applied for, if granted, will be incurred
in the interest of my marriage or family. I understand the creditor
may be required by law to give notice of this credit transaction
to my spouse.