Apply for a Home Equity Loan

Overview

Purpose of Loan:

Amount Requested:

Marital Status

APPLICANT(S) Check one of the following boxes. You may apply for separate or joint credit.

You May Apply for Separate or Joint Credit

Separate Credit (complete Application Section I) Complete Section II with information about your spouse only if you are a married Wisconsin resident.

Joint Credit with Spouse Complete Section I and Section II.

Joint Credit with someone who is not your spouse. Each joint applicant must complete a separate application as if applying for separate credit and submit them together, including completing Section II if you are a married Wisconsin resident.

Joint Credit Individual's name

Applicant: (For secured credit or Wisconsin residents only)

Co-Applicant: (For secured credit or Wisconsin residents only)

Applicant Information Section I

* FIELD REQUIRED

First Name

MI

Last Name

Email Address

Phone Number

Preferred Method of Contact Email Phone

Address Line 1

Address Line 2

City

State

ZIP

Previous Address (if current address is less than 2 years)

Do you Own or Rent? Own Rent

Monthly Rent Payment

Years at Residence

Current Value (if own)

Social Security Number

Date of Birth

Employer

Years at Employer

Position

Annual Income

Work Phone

Previous Employer (if with current employer less than 2 years)

*You need not list income from alimony, child support or separate maintenance unless you wish it considered for the purpose of repaying this obligation.

**A married Wisconsin resident applying for credit in his/her own name must complete the required spousal information in the co-applicant section.

Co-Applicant Joint Credit Section II

Please Check One

Co-Applicant Joint Credit

Spouse Non Applicant

Co-Applicant Information

First Name

MI

Last Name

Phone Number

Address Line 1

Address Line 2

City

State

ZIP

Previous Address (if current address is less than 2 years)

Social Security Number

Date of Birth

Employer

Years at Employer

Position

Annual Income

Work Phone

Previous Employer (if with current employer less than 2 years)

*You need not list income from alimony, child support or separate maintenance unless you wish it considered for the purpose of repaying this obligation.

**A married Wisconsin resident applying for credit in his/her own name must complete the required spousal information in the co-applicant section.

Debts And Obligations

Mortgages

1st Mortgage Lender Name

Address

Monthly Payment

Interest Rate

Unpaid Balance

2nd Mortgage Lender Name

Address

Monthly Payment

Interest Rate

Unpaid Balance

Auto Loans

Auto Lender

Monthly Payment

Unpaid Balance

Credit Cards & Personal Loans

Name of Credit Card / Lender

Minimum Monthly Payment

Unpaid Balance

Name of Credit Card / Lender

Minimum Monthly Payment

Unpaid Balance

Name of Credit Card / Lender

Minimum Monthly Payment

Unpaid Balance

Additional Information (i.e. name of banker you are currently working with, etc.)

Personal Information

The purpose of collecting this information is to help ensure that all applicants are treated fairly and that the housing needs of communities and neighborhoods are being fulfilled. For residential mortgage lending, Federal Law requires that we ask applicants for their demographic information (ethnicity, race, and sex) in order to monitor our compliance with equal credit opportunity, fair housing, and home mortgage disclosure laws. You are not required to provide this information, but are encouraged to do so. You may select one or more designations for "Ethnicity" and one or more designations for "Race". The law provides that we may not discriminate on the basis of this information, or on whether you choose to provide it. However, if you choose not to provide the information and you have made this application in person, Federal regulations require us to note your ethnicity, race, and sex on the basis of visual observation, or surname. If you do not wish to provide some or all of this information, please check below.

Primary Applicant

Ethnicity- check one or more

Hispanic or Latino

Mexican Puerto Rican Cuban Other Hispanic or Latino

Print Origin

For example: Argentinean, Colombian, Dominican, Nicaraguan, Salvadoran, Spaniard, and so on

Not Hispanic or Latino

I do not wish to provide this information

Race- check one or more

American Indian or Alaskan Native

Print Name of enrolled or principal tribe

Asian

Asian Indian Chinese Filipino Japanese Korean Vietnamese Other Asian

If Other Asian, print race For example: Hmong, Laotian, Thai, Pakistani, Cambodian, and so on.

Black or African American

Native Hawaiian or Other Pacific Islander

Native Hawaiian

Guamanian or Chamorro

Samoan

Other Pacific Islander

If Other Pacific Islander, print race For example: Fijian, Tongan, and so on.

White

I do not wish to provide this information

Sex-

Female

Male

I do not wish to provide this information

Marital Status-

Married

Separated

Unmarried (inc. single, divorced, widowed)

Age (Years)-

Co-Applicant (if applicable)

Ethnicity- check one or more

Hispanic or Latino

Mexican Puerto Rican Cuban Other Hispanic or Latino

Print Origin

For example: Argentinean, Colombian, Dominican, Nicaraguan, Salvadoran, Spaniard, and so on

Not Hispanic or Latino

I do not wish to provide this information

Race- check one or more

American Indian or Alaskan Native

Print Name of enrolled or principal tribe

Asian

Asian Indian Chinese Filipino Japanese Korean Vietnamese Other Asian

If Other Asian, print race For example: Hmong, Laotian, Thai, Pakistani, Cambodian, and so on.

Black or African American

Native Hawaiian or Other Pacific Islander

Native Hawaiian

Guamanian or Chamorro

Samoan

Other Pacific Islander

If Other Pacific Islander, print race For example: Fijian, Tongan, and so on.

White

I do not wish to provide this information

Sex-

Female

Male

I do not wish to provide this information

Marital Status-

Married

Separated

Unmarried (inc. single, divorced, widowed)

Age (Years)-

Authorizations

Authorization to Release Information

I authorize Port Washington State Bank to obtain my/our credit report for the purpose of determining credit worthiness. The information that is obtained is strictly confidential. A photocopy or fax of this authorization may be deemed to be the equivalent of the original.

For Married Applicant Applying for Separate Credit

The credit being applied for, if granted, will be incurred in the interest of my marriage or family. NOTICE TO MARRIED APPLICANTS: No provision of any marital property agreement, unilateral statement under s788.58, Wis Stats, or court decree under s788.70 adversely affects the interest of the creditor unless the creditor, prior to the time the credit is granted, is furnished a copy of the agreement, statement or decree or has actual knowledge of the adverse provision when the obligation to the creditor is incurred.

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Co-Applicant Information

Mortgages

Auto Loans

Credit Cards & Personal Loans

Primary Applicant

Co-Applicant (if applicable)