Security Bank Minnesota - Consumer Loan Application

Today's Date*

Please select today’s date.

Do you have a previous relationship with us?*

Yes

Please select yes or no.

What services do you currently use?

Please select at least one service.

Will there be a joint applicant?*

Yes

Please select yes or no.

Applicant Information

FirstName*

Please enter your first name.

LastName*

Please enter your last name.

Date of Birth*

Please enter your date of birth.

Social Security Number*

Please enter a valid 9 digit Social Security Number, either 000000000 or 000-00-0000.

Primary Phone*

Please enter a valid phone number.

Secondary Phone

Please enter a valid phone number.

Email*

Please enter a valid email address.

Driver’s License Number*

Please enter your driver’s license number.

Current Address

Street Address*

Please enter your current street address

City*

Please enter your current city.

State*

Please select your current state.

Postal / Zip Code*

Please enter a 5 digit zip code.

Country*

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How long at your current address?*

Please enter how long you have lived at your current address.

Number of Dependents

Please enter the number of dependents.

Previous Address

Street Address

Please enter your previous street address.

City

Please enter your previous city.

State

Please select your previous state.

Postal / Zip Code

Please enter your previous zip code.

Country

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How long at your previous address?

Please enter how long you lived at your previous address.

Applicant Employment Information

Employer*

Please enter your employer name.

Employer City*

Please enter your employer city.

Work Phone*

Please enter a valid phone number.

Monthly Income (Yours Alone)*

Please enter your monthly income.

How long at this job?*

Please enter how long you have been at this job.

Position*

Please enter your position.

Previous Employer Name*

Please enter your previous employer name.

How long at previous job?*

Please enter how long you were at your previous job.

Applicant References

Name of nearest relative not living with you*

Please enter the nearest relative’s name.

Relationship*

Please enter the relationship.

Nearest Relative Phone*

Please enter a valid phone number.

Nearest Relative Address

Street Address

Please enter the address.

City

Please enter the city.

State

Please select the state.

Postal / Zip Code

Please enter the zip code.

Country

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Personal Reference #1 Name*

Please enter the reference name.

Personal Reference #1 Phone*

Please enter a valid phone number.

Personal Reference #1 Address

Street Address

Please enter the address.

City

Please enter the city.

State

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Postal / Zip Code

Please enter the zip code.

Country

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Personal Reference #2 Name

Please enter the reference name.

Personal Reference #2 Phone

Please enter a valid phone number.

Personal Reference #2 Address

Street Address

Please enter the address.

City

Please enter the city.

State

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Postal / Zip Code

Please enter the zip code.

Country

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Bank Reference Name

Please enter the bank name.

Bank Reference Address

Street Address

Please enter the bank address.

City

Please enter the city.

State

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Bank Reference Zip Code

Please enter the zip code.

Country

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Type of Account

Please enter the account type.

Joint Applicant Information

First Name*

Please enter your first name.

Last Name*

Please enter your last name.

Date of Birth*

Please enter the date of birth.

Joint Applicant's Social Security Number*

Please enter a valid 9 digit Social Security Number, either 000000000 or 000-00-0000.

Primary Phone*

Please enter a valid phone number.

Secondary Phone

Please enter a valid phone number.

Email*

Please enter a valid email address.

Driver’s License Number

Please enter the driver’s license number.

Current Address

Street Address*

Please enter the street address.

City*

Please enter the city.

State*

Please select the state.

Potsal / Zip Code*

Please enter the zip code.

Country*

Invalid Input

How long at current address?

Please enter how long you have lived at this address.

Number of dependents

Please enter the number of dependents.

Previous Address

Street Address

Please enter your previous street address.

City

Please enter your previous city.

State

Please select your previous state.

Postal / Zip Code

Please enter your previous zip code.

Country

Invalid Input

How long at your previous address?

Please enter how long you lived at your previous address.

Joint Applicant Employer Information

Employer Name*

Please enter the employer name.

Employer City*

Please enter the employer city.

Work Phone*

Please enter a valid phone number.

Monthly Income (Yours Alone)*

Please enter the monthly income.

How long at this job?*

Please enter how long you have been at this job.

Position*

Please enter the position.

Previous Employer Name

Please enter the previous employer name.

How long at previous job?

Please enter how long you worked at the previous job.

Joint Applicant References

Name of nearest relative not living with you*

Please enter the nearest relative’s name.

Relationship*

Please enter the relationship.

Nearest Relative Phone*

Please enter a valid phone number.

Joint Applicant's Nearest Relative Address

Street Address

Please enter the address.

City

Please enter the city.

State

Please select the state.

Postal / Zip Code

Please enter the zip code.

Country

Invalid Input

Personal Reference #1 Name*

Please enter the reference name.

Personal Reference #1 Phone*

Please enter a valid phone number.

Joint Applicant's Personal Reference #1 Address

Street Address

Please enter the address.

City

Please enter the city.

State

Invalid Input

Postal / Zip Code

Please enter the zip code.

Country

Invalid Input

Personal Reference #2 Name

Please enter the reference name.

Personal Reference #2 Phone

Please enter a valid phone number.

Joint Applicant's Personal Reference #2 Address

Street Address

Please enter the address.

City

Please enter the city.

State

Invalid Input

Postal / Zip Code

Please enter the zip code.

Country

Invalid Input

Bank Reference Name

Please enter the bank name.

Joint Applicant's Bank Reference Address

Street Address

Please enter the bank address.

City

Please enter the city.

State

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Bank Reference Zip Code

Please enter the zip code.

Country

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Type of Account

Please enter the account type.

Loan Information

Purpose of the Loan*

Please enter the purpose of the loan.

Term Requested (Months)*

Please enter the loan term in months.

Amount Requested*

Please enter the requested amount.

Total Credit Card Debt

Please enter total credit card debt.

Current Checking Account Balance*

Please enter your checking account balance.

Total Savings

Please enter your total savings.

Do you rent or own your home?*

Own

Rent

Please select rent or own.

Mortgage Holder*

Please enter your mortgage holder.

Mortgage Payment*

Please enter your mortgage payment.

Original Mortgage Amount*

Please enter the original amount of your mortgage.

Current Mortgage Balance*

Please enter your current mortgage balance.

Estimate Of Property Value

Please enter the estimated value of your property.

Landlord*

Please enter your landlord's name.

Monthly Rent*

Please enter your monthly rent.

Automobile #1 (Make, Model, Year)

Please enter automobile details.

Lien Holder

Please enter the lien holder.

Payment Amount

Please enter the payment amount.

Loan Balance

Please enter the loan balance.

Automobile #2 (Make, Model, Year)

Please enter automobile details.

Lien Holder

Please enter the lien holder.

Payment Amount

Please enter the payment amount.

Loan Balance

Please enter the loan balance.

Are you paying or receiving child support or alimony?*

Yes

Please select yes or no.

Amount per Month*

Please enter the monthly amount.

Monthly Income from alimony, child support or maintenance (You need not reveal alimony, child support, or separate maintenance income if you do not wish to have it considered as a basis for repaying this loan.)

Please enter the income amount.

Is your maintenance or child support income or payment included in the monthly income figure you listed?*

Yes

Please select yes or no.

How long will the income / payments continue?*

Please enter the duration.

Name of person who pays you child support or maintenance*

Please enter the payer’s name.

Name of Employer of the person paying child support*

Please enter the employer name of the person paying child support.

Address of person who pays you child support or maintenance

Street Address*

Please enter the address.

City*

Please enter the city.

State*

Please select the state.

Postal / Zip Code*

Please enter the zip code.

Country:*

Invalid Input

Have you ever been convicted of a felony?*

Yes

Please select yes or no.

Have you ever filed for bankruptcy?*

Yes

Please select yes or no.

Primary Applicant’s Signature*

Sign Above

Please provide your signature.

Joint Applicant’s Signature*

Sign Above

Please provide your signature.

Consumer Loan Application

Online Banking

Albert Lea

437 Bridge Ave.
Albert Lea, MN 56007

Alden

195 North Broadway
Alden, MN 56009

Emmons

201 Main St.
Emmons, MN 56029

Consumer Loan Application

Online Banking

Albert Lea

437 Bridge Ave.Albert Lea, MN 56007

Alden

195 North BroadwayAlden, MN 56009

Emmons

201 Main St.Emmons, MN 56029

437 Bridge Ave.
Albert Lea, MN 56007

195 North Broadway
Alden, MN 56009

201 Main St.
Emmons, MN 56029