Consumer Loan Application

This application is for Non-Real Estate loans only. For Mortgage information, click here.

Consumer Loan Application

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IMPORTANT APPLICANT INFORMATION: 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 applies for a loan or opens an account. What this means for you. When you apply for a loan or open an account, we will ask for your name, address, date of birth, and other information that will allow us to identify you. We may also ask to see your driver's license or other identifying documents. In some instances, we may use outside sources to confirm the information. The information you provide is protected by our privacy policy and federal law. Read each instruction carefully before completing this form.

This application takes on average 15 minutes to complete. If necessary, you can save your progress and complete this application at another time without losing your information. After you submit the completed application, it will be processed and you will then be contacted by BSV with the status.



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Federal Credit Application Insurance Disclosure

 

I/We are applying 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 YOU FROM CONDITIONING THE EXTENSION OF CREDIT ON EITHER:

     1. My purchase of an insurance product or annuity from you or from any of your affiliates; or
     2. My agreement not to obtain, or a prohibition on me from obtaining, an insurance product or                     annuity from an unaffiliated entity.

By agreeing below, I/we acknowledge that I/we have received a copy of this form on today's date. Unless this disclosure is provided electronically or I have applied for credit by mail, I/we also acknowledge that you have provided this disclosure orally.


Section A - Applicant Information

Primary Borrower Information











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Driver's License Information



Employment







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Other Sources of Income
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. 


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Relatives
The information in this section should all pertain to the nearest relative not living with you.










Co-Borrower Information






















Driver's License Information



Employment







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Other Sources of Income
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. 


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Section B - Asset & Debt Information

Primary Applicant Assets



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Co-Applicant Assets



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Primary Applicant Debts



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Co-Applicant Debts



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Primary Applicant Additional Information



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Co-Applicant Additional Information



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I certify that everything I have stated in this Credit Application and on any other documents submitted is true and correct to the best of my knowledge. By submitting this application, I authorize The Bank of Southside Virginia to check my credit and employment history and to answer questions others may ask The Bank of Southside Virginia about my credit record with The Bank of Southside Virginia. I understand that I must update the information contained in this Credit Application if either my financial condition materially changes or if BSV makes a request to me orally or in writing. I understand that BSV will retain this Credit Application whether or not it is approved.