Loan Services Application Form

Use this online application to apply for a loan at Liberty Savings Bank. Simply fill out the appropriate fields and then print this form. Bring the printed out application to any Liberty branch location.

Please read the disclosure for information.

Note: Loans are limited to properties located in Minnesota.

Will there be a co-applicant on this loan application? Yes No

Amount Requested: Type of Loan:

Loan Purpose:

It is Liberty Savings Bank’s policy to never sell customer information. Prior to providing Libery Savings Bank with any personal information, would you like to review Liberty Savings Bank’s privacy policy? Click here if you would like to read the policy.

Liberty Savings Bank complies with the Federal Customer Identification Program. Prior to providing Liberty Savings Bank with any personal information would you like to review Liberty Savings Bank Customer Identification Notice?
Click here if you would like to read the notice.

*Fields in red must be answered, if applicable, in order to complete your application.
Application cannot be submitted without providing an E-mail address.
No social security number will be requested. A representative from Liberty Savings Bank will contact you to complete this form and add your social security number.

Primary Applicant
*Last Name
*First Name
*Birth Date mm/dd/yyyy
*E-mail Address
*Address
*City:
*State / ZIP:	/
*Residence Status
*Years at this address
If you have lived at your address less than two years, provide your previous address
*Home Phone (nnn) nnn-nnnn
*Work Phone (nnn) nnn-nnnn
*Employers Name & Address	Self Employed
# of years employed
Postition/Title
Previous Employer Name & Address (if less than 2 years in current position)	Self Employed
# of years employed
Postition/Title
*Gross Income	Hourly Monthly Annually
Other Income
Source of Other Income

Joint Applicant (If applicable)
*Fields in red must be answered, if applicable, in order to complete your application.

Joint Applicant
*Last Name
*First Name
*Birth Date mm/dd/yyyy
*E-mail Address
*Address
*City:
*State / ZIP:	/
*Residence Status
*Years at this address
If you have lived at your address less than two years, provide your previous address
*Home Phone (nnn) nnn-nnnn
*Work Phone (nnn) nnn-nnnn
*Employers Name & Address	Self Employed
# of years employed
Postition/Title
Previous Employer Name & Address (if less than 2 years in current position)	Self Employed
# of years employed
Postition/Title
*Gross Income	Hourly Monthly Annually
Other Income
Source of Other Income

Assets

	Description	Value
Checking and Savings Accounts



Life Insurance
Autos Make and Model


Real Estate Owned
	Annual Real Estate Taxes

	Annual Real Estate Taxes
Other Assets
Other Assets

*Insurance on Collateral
Insurance Company
Agent Name
Phone Number
Homeowner's Insurance Annual Premium

Liabilities

Item	Creditor Name	Balance Owed	To be paid off?	Monthly Payment
Mortgage or Rent
Mortgage or Rent
Vehicle Loans
Vehicle Loans
Personal Loans
Personal Loans
Mortgage or Rent



Other Creditors
Other Creditors
Alimony
Child Support
Maintenance Payments
Maintenance Payments