Loan Request Form

The first step to getting the personal financing you need is to fill out our online loan request form. Simply enter in the required information below and submit the form. You will receive a confirmation at the top of this page upon completion. If you do not, verify that all fields are completed. A Peoples Bank loan officer will then be in contact with you to guide you through the next steps to obtaining a loan. If you are not contacted by a Peoples Bank representative by the next business day, please feel free to give us a call to verify that your request was received. You can contact us for any questions regarding the loan application process at any time by contacting Terrell Yeiser in Hohenwald at 931-796-3777 or Hayden Kelly at our Waynesboro Office 931-253-2370.

Thank you for considering Peoples Bank for your financing needs!

Individual

Joint

This is an application for joint credit. Borrower and Co-Borrower each agree to apply for joint credit.

This is an application for credit with a co-signer. Borrower and Co-Signer each agree to apply for joint credit.

Loan Type *

Amount Requested *

Collateral Description *

Preferred Officer *

Name

First Name *

Middle Name

Last Name *

Date of Birth *

Social Security Number *

Marital Status *

Spouse Name

Present Address

Street *

City *

State * (Present address)

Zip *

E-Mail Address *

Phone Number

Home Phone Number

Cell Phone Number *

Driver's License Information

State * (Driver's license)

License Number *

Issue Date *

Expiration Date *

Account Information

Current Deposit Accounts *

Account Number

Employment Information

Current Employer/Source of Income *

Occupation

Years at Current Employer

Years Employed in This Profession

Primary Gross Income (annually) *

Other Sources of Income

Other sources of income

Monthly Mortgage/Rent Payment Amount *

Additional Monthly Liabilities *

Joint Applicant/Co-Borrower's Information

Joint Applicant Name

Preferred Officer *

First Name * (Joint Applicant)

Middle (Joint Applicant)

Last Name * (Joint Applicant)

Date of Birth * (Joint Applicant)

Social Security Number * (Joint Applicant)

Marital Status *

Spouse Name

Joint Applicant's Present Address

Street * (Joint Applicant)

City * (Joint Applicant)

State * (Joint applicant's present address)

Zip * (Joint Applicant)

Joint Applicant's Phone Number

Home Phone Number (Joint Applicant)

Cell Phone Number * (Joint Applicant)

Joint Applicant's Driver's License Information

State * (Joint applicant's Driver's license)

License Number * (Joint Applicant)

Account Information

Current Deposit Accounts *

Account Number

Issue Date * (Joint Applicant)

Expiration Date * (Joint Applicant)

Joint Applicant's Employment Information

Current Employer/Source of Income * (Joint Applicant)

Occupation (Joint Applicant)

Years at Current Employer (Joint Applicant)

Years Employed in This Profession (Joint Applicant)

Primary Gross Income (annually) * (Joint Applicant)

Joint Applicant's Other Sources of Income

Other sources of income for joint applicant

Monthly Monthly/Rent Payment Amount * (Joint Applicant)

Additional Monthly Liabilities * (Joint Applicant)

I/We hereby request for a loan or credit described in this form. I/We certify that I/we made no misrepresentations in this loan request or in any related documents, that all information is true and complete, and that I/we did not omit any important information. I/We agree that any property securing the loan or credit will not be used for any illegal or restricted purpose. Lender is authorized to verify with other parties and to make investigation of my/our credit, either directly through any agency employed by Lender for that purpose. Lender may disclose to any other interested parties information as to Lender's experiences or transaction with my/our account. I/We understand that Lender will retain this form and any other credit information Lender receives, even if no loan or credit is granted.

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I have read and agree to the terms *

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Peoples Bank

Loan Request Form

Applicant's Information

Name

Present Address

Phone Number

Driver's License Information

Account Information

Employment Information

Other Sources of Income

Joint Applicant/Co-Borrower's Information

Joint Applicant Name

Joint Applicant's Present Address

Joint Applicant's Phone Number

Joint Applicant's Driver's License Information

Account Information

Joint Applicant's Employment Information

Joint Applicant's Other Sources of Income

Thank you for your loan request!