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When you have completed the application, please click the Submit button to forward your information to the First National Bank via our Secure Server.

* If you are outside of these counties, please contact First National Bank Bemidji at 218-333-4320  to talk to a loan officer.

Loan Information

What kind of loan are you applying for?
If other, please specify here: 
How much would you like to borrow?
For how Long? 
When will you need this money? Date:
 Please check one:
Individual credit - relying solely on my income
Individual credit - relying on my income as well as income from other sources
Joint Credit - relying on my income and the income of others
Depending upon the type of loan you are applying for, additional information may be required.

Primary Applicant Information

First Name:
Middle Initial:
Last Name:
Social Security Number:  
Birth date (MM/DD/YYYY)
Phone Number:
Email Address
Residential Address:
   City:
   State:
   Zip:
Mailing Address: (if different)
 Mailing  City:
 Mailing  State:
 Mailing   Zip:
County:
Township:
Do you  Own or Rent    Other , please explain below
Other: 
How Long at this address?
If you've lived at your current address less than 2 years, please provide your previous home address:
Previous Home Address:
   City:
   State:
   Zip:

FNBB Loan Officer

Name of Officer at First National Bank Bemidji (if any) that I would like this application referred to:

Employment Information

Employer name:
Work Phone Number:
    Address:
    City:
    State:
    Zip:
Occupation:
Time at this job:
Previous Employer name: (if less than one year at current job)
    Address:
    City:
    State:
    Zip:
Occupation:
Time at this job:

Joint Applicant  Information  
 (if none, please skip down)

First Name:
Middle Initial:
Last Name:
Social Security Number:
Birth date (xx/xx/xxxx)
Phone:
Email Address
Home Address:
   City:
   State:
   Zip:
Mailing Address: (if different)
 Mailing  City:
 Mailing  State:
 Mailing   Zip:
County:
Township:
How Long at this address?
If you've lived at your current address less than 2 years, please provide your previous home address:
Previous Home Address:
   City:
   State:
   Zip:

Joint Applicant  Employment Information

Employer name:
Work Phone Number:
    Address:
    City:
    State:
    Zip:
Occupation:
Time at this job:
Previous Employer name: (if less than one year at current job)
    Address:
    City:
    State:
    Zip:
Occupation:
Time at this job:

Primary Applicant Income & Asset Information

Gross monthly income:
Gross monthly income (joint applicant):
Other income Note: Alimony, child support or separate maintenance income need not be revealed if you do not wish to have it considered as a basis for repaying this obligation.
Amount:
Source: 
Other income, joint applicant: Note: Alimony, child support or separate maintenance income need not be revealed if you do not wish to have it considered as a basis for repaying this obligation.
Amount:
Source: 
Real Estate-  value
Real Estate-  value
Auto - year, make model
Auto - year, make model
Other Asset
Other Asset
Accounts with FNB Bemidji? Checking  Savings
Joint applicant accounts with FNB Bemidji?  Checking  Savings
Accounts with other institution? Checking  Savings
What Institution
Accounts with other institution? Checking  Savings
What Institution

Primary Applicant Debt Information 

List all debts and credit accounts, replacing "Other" with description. If those listed do not apply, please say "None" for  balance & payment..

Balance Monthly Payment
Rent or Mortgage
Credit Card
Auto Payments
Do you have any other unlisted debt?  Yes    No   
    Joint:  Yes    No 
Have you ever filed bankruptcy?  Yes    No   
    Joint: Yes    No    
Are you a co-signer, endorser, or guarantor for anyone? Yes    No        
   Joint:  Yes    No 
Are there any claims, suit or judgments against you? Yes    No 
   Joint:  Yes    No 

References

Bank References  - Name and City 

Please check which services you have with this financial institution.

Checking  Credit Line  Loans  Savings  Other

Applicant Personal Reference 

Personal Reference Name:  

Address:  

City, State & Zip:   

Phone number:

Nearest relative not living with you: 

Address: 

City, State & Zip: 

Phone number: 

Other reference name: 

Address:

City, State & Zip:

Phone number:

If you prefer, you may print this form and fax or mail it to:

First National Bank  Bemidji
PO Box 670
Bemidji, MN 56619-0670 

Fax 218-333-4355

 

If you print this form to mail it to First National Bank Bemidji, you must sign the application below.

 

 

FEDERAL CREDIT APPLICATION INSURANCE DISCLOSURE

I have applied for an extension of credit with you.  You are soliciting, offering, or selling me an insurance product or annuity in connection with this extension of credit.  Federal law prohibits First National Bank of Bemidji from conditioning the extension of credit on either:

 

*My purchase of an insurance product or annuity from you or;

*My agreement not to obtain, or a prohibition on me from obtaining, an insurance product from an unaffiliated entity.

 

By signing, I acknowledge that First National Bank of Bemidji has given me the opportunity to receive a copy of this form on today's date.  Unless this disclosure is provided electronically or I have applied for credit by mail, I also acknowledge that this disclosure was provided to me orally.

IMPORTANT INFORMATION ABOUT PROCEDURES FOR OPENING A NEW ACCOUNT

To help the government fight the funding of terrorism and money laundering activities, Federal law requires all financial institutions to obtain, verify, and record information that identifies each person who opens an account.

What this means for you:  When you open an account, we will ask for your name, address, date of birth, and other information that will allow us to identify you.  We will also ask to see your driver's license or other identifying documents.

By signing or submitting this application, you understand and agree that:

  1. You have read all applicable credit disclosures;
  2. The information on this application is true and complete;
  3. The bank is authorized to check your credit and employment history; and
  4. The bank is authorized to inspect any collateral, after giving reasonable notice to you.

Applicant: 
Type or Sign Name Here ____________________________________

Joint Applicant:
Type or Sign Name Here ____________________________________

 

If you do not print this out, please now submit your application to the First National Bank of Bemidji.

   

the application.

A First National Bank Bemidji employee will contact you within one business day, to discuss your application.

 

 

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