Credit Application

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 opens an account. What this means for you: When you open an account or apply for a loan, we will ask your name, address, date of birth, and other other information that will allow us to identify you. We may also ask to see your driver's license or other identifying documents.

Please indicate whether you intend to apply for individual or joint credit. Applicants for joint credit should complete the applicable co-borrower sections of the application. Co-borrower information must be provided when the income or assets of a person other than the "Borrower" (including the Borrower's spouse) will be used as a basis for loan qualification, or the income or assets of the Borrower's spouse will not be used as a basis for loan qualification, but his or her liabilities must be considered because the Borrower resides in a community property state, the secured property is located in a community property state, or the Borrower is relying on other property located in a community property state as a basis for repayment of the loan.

You must be a U.S. Citizen with a U.S. address and Social Security number to apply online. All other applicants should contact us at (337) 826-3641.

Application Information

Application Type

Borrower

Do you rent or own?

Do you rent or own?


Marital Status
Notice: Marital status should only be completed if applicant is applying for joint or secured credit, or if applicant resides in a community property state, or is relying on property located in such a state.
Dependents other than listed by Co-Borrower:



Co-Borrower

Do you rent or own?

Do you rent or own?


Marital Status
Notice: Marital status should only be completed if applicant is applying for joint or secured credit, or if applicant resides in a community property state, or is relying on property located in such a state.
Dependents other than listed by Borrower:



Income Information

Gross Monthly Income

Borrower

Co-Borrower

Total


Monthly Housing Expenses


Describe Other Income

NOTICE
+ Alimony, child support, or separate maintenance income need not be revealed if the Borrower or Co-Borrower does not choose to have it considered as a basis for repaying this loan.


If employed in current position less than 2 years, complete the following:

First Previous Employer/School Info


Second Previous Employer/School Info


Third Previous Employer/School Info


These Questions Apply to Both Borrowers

If a yes answer is given to a question in this section, you will be asked to explain during the initial application interview.

Have you any outstanding judgements?
Borrower
Co-Borrower
In the last 14 years, have you been bankrupt?
Borrower
Co-Borrower
Have you had property foreclosed upon or given title or deed in lieu of?
Borrower
Co-Borrower
Are you a party in a law suit?
Borrower
Co-Borrower
Are you a co-maker or endorser on a note?
Borrower
Co-Borrower
Are you obligated to pay alimony, child support, or separate maintenance?
Borrower
Co-Borrower
Do you have health and accidental insurance?
Borrower
Co-Borrower
Do you have major medical coverage?
Borrower
Co-Borrower
Are you a U.S. Citizen?
Borrower
Co-Borrower
Are you a permanent resident alien?
Borrower
Co-Borrower

Assets & Liabilities

This statement and any applicable supporting schedules may be completed jointly by both married and unmarried co-borrowers if assets and liabilities are sufficiently joined so that the Statement can be meaningfully and fairly presented on a combined basis; otherwise separate statements and schedules are required. If the co-borrower section was completed about a spouse, this statement and supporting schedules must also be completed about the spouse.

Completed:

List of Assets

Cash or Market Value
Cash or Market Value
Cash or Market Value
Automobiles owned (make and year)

Liabilities and Pledged Assets

List the creditor's name, address, and account number for all outstanding debts, including automobile loans, revolving charge accounts, real estate loans, alimony, child support, stock pledges, etc.

Alimony/Child Support/Separate Maintenance Payments Owed to
Job Related Expenses (child cars, union dates, etc.)

Schedule of Real Estate Owned

Totals

List of previous Credit References


Disclosure: I/We certify that the information on this application is true and complete to the best of my/our knowledge. Washington State Bank is authorized to verify, exchange, and retain credit and employment information contained herin and relative to this application.

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