Consumer Credit Application
Dealer: -
Application Type: include Co-applicant information section if married and a Wisconsin resident or living in a community property state
  ___ Separate Credit
___ Joint Credit with Spouse
___ Joint Credit with _________________________ (not your Spouse)
MaritalStatus: indicate your marital status below only if the loan is for secured credit or you live in a community property state (such as Wisconsin)
  ___ Married     ___ Unmarried
Applicant Information
Name
                                                                  
DOB
                                  
SSN
                                  
Phone
                                  
Address
                                                                          
City
                                                  
State
                  
Zip
                          
Type
  __ Own  __ Rent
Mortgage Holder/Landlord
                                                                                  
Monthly Payment
                                                  
Length
               yrs               mos  
Employer
                                                  
Position
                                  
Work Phone
                                
Length
                          
Salary
                          
Other Income Source
                                                                  
Amount
                                  
E-Mail Address
                                                                  
Are you obligated to pay child support or Alimony?
                                                                                  
Amount
                                          
Until
                                          
Have you ever filed for bankruptcy?
                                                                  
Are there any suits, judgments unsatisfied, alimony or maintenance awards pending against you?
                                                                                                  
Name, Address & Phone of Nearest Relative not living with you
  
 
Co-Applicant Information  -   ___ Spouse  ___ Joint Applicant   ___ Non-Applicant (Spouse)
Name
                                                                  
DOB
                                  
SSN
                                  
Phone
                                  
Address
                                                                          
City
                                                  
State
                  
Zip
                          
Employer
                                                  
Position
                                  
Work Phone
                                
Length
                          
Salary
                          
Other Income Source
                                                                  
Amount
                                  
E-Mail Address
                                                                  
Name, Address & Phone of Nearest Relative not living with you
  
 
Collateral
Check One: ___ New   ___ Used
Check One: __ Auto  __ Boat  __ RV    __ Cycle
Year:                                 
Make:                                 
Model:                                 
Options:                                 
For boats, complete info below
Motor Year:                                 
Motor Make:                                 
Motor Model:                                 
Trailer Year:                                 
Trailer Make:                                 
Trailer Model:                                 
Terms of Purchase  Term (months):             
Purchase Price: $                                 
Down Payment: $                                 
Trade-In: ___ Yes     ___ No
Trade In Allowance: $                                 
Owed on Trade: $                                 
Sales Tax: $                                 
License Fee: $                                 
Title Fee: $                                 
Doc Prep Fee: $                                 
Delivery Fee: $                                 
UCC Fee: $                                 
Other Fee: $                                 
Amount Financed: $                                 



For the purpose of obtaining the credit described herein, by the creditor named above. The undersigned state the information is true and complete and further agrees that this application is the property of North Shore Bank which may provide this information to others. North Shore Bank or anyone authorized by North Shore Bank may inspect any property for the purpose of determining value which may become security for the credit which the undersigned is applying. The undersigned further understands that it may be a federal crime punishable by fine or imprisonment or both to knowingly make any false statements concerning any of the facts as provided under Title 18, United States Code, Section 1014.

Marital Purpose Statement: That the undersigned further states "I am applying for credit which will be incurred in the interest of my marriage or family. I authorize North Shore Bank to consider the income and marital assets of my spouse, as well as my own income and assets, in deciding whether or not to grant the credit for which I am applying."

Notice to married applicants living in Wisconsin:. No provision of any marital property agreement, unilateral statement under section 766.59 of the Wisconsin Statutes, or court order under section 766.70 adversely affects the interest of North Shore Bank unless North Shore Bank is furnished a copy of the agreement, statement, or order or has acute knowledge of the adverse provision before opening the requested account.

If you are married and live in Wisconsin, and if we open an individual account for you, we are required by section 755.56 (3) (b) of the Wisconsin Statures to notify your spouse of the opening of the account.

Joint applicants who are married, but not to each other, should complete separate applications and submit them together.

Credit Release and Authorization

I / We hereby authorize North Shore Bank, FSB ("North Shore"), 15700 W. Bluemound Road, Brookfield, WI 53005, to verify my past and present employment earnings records, bank accounts, stock holdings and any other asset balances that are needed to process my loan application. I further authorize North Shore to order a consumer credit report and verify other credit information including past and present mortgage loan, consumer loan, and landlord references.

I / We authorize North Shore to conduct investigations and inquiries as to credit and collateral in connection with considering the loan application. North Shore is authorized to discuss the details of my application with the other parties of my purchase or refinance transaction, as North Shore deems necessary and appropriate.

I / We intend to apply jointly - initials:   _______________     _______________


Applicant Applicant
Date Date

Abbreviated Personal Financial Statement

INCOME (please list each applicant separately)
    AMOUNT/YEAR DESCRIPTION (SSI, Pension, etc)
  SOURCE #1    
  SOURCE #2    
  SOURCE #3    
  SOURCE #4    
  SOURCE #5    
  Total Income ___________
INVESTMENTS (current market value)
    AMOUNT/YEAR DESCRIPTION (SSI, Pension, etc)
  401K    
  401K    
  IRA    
  IRA    
  Stocks    
  Other    
      DESCRIPTION (residence, rental, vacation property)
  Property #1    
  Property #2    
  Total Investments ___________