December 14, 2024
FSNB Checking Account Number : * Please enter your FSNB Checking Account Number Account number must only contain digits Don't have an account? Click Here
FSNB Savings Account Number : Account number must only contain digits
What type of loan would you like? : Please select Loan Type ... Secured Unsecured * Please choose a Loan Type
Loan Purpose: *
Amount Requested : $ * Please enter a loan amount Must be in a valid monetary format (e.g. 100.00)
Term Requested (in months) : *
Referred By :
Required fields are marked with an asterisk (*)
First Name : * Please enter your First Name Please enter letters only
Last Name : * Please enter your Last Name Please enter letters only
Date of Birth : * Please enter your Date of Birth
Social Security Number : * Please enter your full Social Security Number Please enter exactly 9 digits (digits only)
Cell Phone Number : * Please enter your Cell Phone Number (digits only) Please enter exactly 10 digits (digits only)
Home Phone Number : * Same as Cell Phone Please enter your Home Phone Number (digits only; use cell phone number if no home phone) Please enter exactly 10 digits (digits only)
E-mail Address : * Please enter your email address Please check the format of your email address
House Number / Building Number : * Please enter your House or Building Number
Street Name : * Please enter the name of your street
Apartment / Suite Number :
City : * Please enter the city where you live Please enter a valid city
State : Please select State ALABAMA ALASKA ARIZONA ARKANSAS CALIFORNIA COLORADO CONNECTICUT DELAWARE DISTRICT OF COLUMBIA FLORIDA GEORGIA HAWAII IDAHO ILLINOIS INDIANA IOWA KANSAS KENTUCKY LOUISIANA MAINE MARYLAND MASSACHUSETTS MICHIGAN MINNESOTA MISSISSIPPI MISSOURI MONTANA NEBRASKA NEVADA NEW HAMPSHIRE NEW JERSEY NEW MEXICO NEW YORK NORTH CAROLINA NORTH DAKOTA OHIO OKLAHOMA OREGON PENNSYLVANIA RHODE ISLAND SOUTH CAROLINA SOUTH DAKOTA TENNESSEE TEXAS UTAH VERMONT VIRGINIA WASHINGTON WEST VIRGINIA WISCONSIN WYOMING AA - MILITARY AMERICAS AE - MILITARY EUROPE AP - MILITARY PACIFIC AMERICAN SAMOA FEDERATED STATES OF MICRONESIA GUAM MARSHALL ISLANDS NORTHERN MARIANA ISLANDS PALAU PUERTO RICO VIRGIN ISLANDS ALBERTA BRITISH COLUMBIA MANITOBA NEW BRUNSWICK NEWFOUNDLAND NORTHWEST TERRITORIES NOVA SCOTIA NUNAVUT ONTARIO PRINCE EDWARD ISLAND QUEBEC SASKATCHEWAN YUKON TERRITORY UNKNOWN STATE * Please select the State where you live
Zip Code : * Please enter the zip code where you live Please enter exactly 5 digits (digits only)
Current Employer or Branch of Service : * Please enter the name of your current employer Please enter a valid name for your current employer
Employer Address or Military Unit : * Please enter the address of your current employer Please enter a valid address for your current employer
Work Phone : * Please enter the phone number of your current employer Please enter exactly 10 digits (digits only)
Hire Date : * Please enter your Hire Date
Position or Rank : * Please enter your position or rank Please enter a valid position or rank
ETS/ESA (military only) :
Type of Business : * Please enter the type of business you work for Please enter a valid business type
Monthly Net Income : $ * Please enter your monthly net income Must be in a valid monetary format (e.g. 100.00)
Other Income : $ Must be in a valid monetary format (e.g. 100.00)
Source of Other Income : Please enter a valid Other Income source
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.
Nearest Relative Information: (MUST not be living with you; MUST be other than present or former spouse)
Relative's Name : * Please enter the full name of your nearest relative Please enter letters only
Relative Street Address : * Please enter the street address of nearest relative
Relative City : * Please enter the city where nearest relative lives Please enter a valid city
Relative State : Please select State ALABAMA ALASKA ARIZONA ARKANSAS CALIFORNIA COLORADO CONNECTICUT DELAWARE DISTRICT OF COLUMBIA FLORIDA GEORGIA HAWAII IDAHO ILLINOIS INDIANA IOWA KANSAS KENTUCKY LOUISIANA MAINE MARYLAND MASSACHUSETTS MICHIGAN MINNESOTA MISSISSIPPI MISSOURI MONTANA NEBRASKA NEVADA NEW HAMPSHIRE NEW JERSEY NEW MEXICO NEW YORK NORTH CAROLINA NORTH DAKOTA OHIO OKLAHOMA OREGON PENNSYLVANIA RHODE ISLAND SOUTH CAROLINA SOUTH DAKOTA TENNESSEE TEXAS UTAH VERMONT VIRGINIA WASHINGTON WEST VIRGINIA WISCONSIN WYOMING AA - MILITARY AMERICAS AE - MILITARY EUROPE AP - MILITARY PACIFIC AMERICAN SAMOA FEDERATED STATES OF MICRONESIA GUAM MARSHALL ISLANDS NORTHERN MARIANA ISLANDS PALAU PUERTO RICO VIRGIN ISLANDS ALBERTA BRITISH COLUMBIA MANITOBA NEW BRUNSWICK NEWFOUNDLAND NORTHWEST TERRITORIES NOVA SCOTIA NUNAVUT ONTARIO PRINCE EDWARD ISLAND QUEBEC SASKATCHEWAN YUKON TERRITORY UNKNOWN STATE * Please select the State where nearest relative lives
Relative Zip Code : * Please enter the zip code where nearest relative lives Please enter exactly 5 digits (digits only)
Relative Phone : * Please enter the phone number of nearest relative Please enter exactly 10 digits (digits only)
Relationship to you : * Please enter the relationship to you of your nearest relative Please enter letters only
Mortgage or Rent: Balance : $ Must be in a valid monetary format (e.g. 100.00) Payment : $ * Please enter a monthly mortgage or rent payment amount Must be in a valid monetary format (e.g. 100.00)
Automobile: Balance : $ Must be in a valid monetary format (e.g. 100.00) Payment : $ Must be in a valid monetary format (e.g. 100.00)
Other: Balance : $ Must be in a valid monetary format (e.g. 100.00) Payment : $ Must be in a valid monetary format (e.g. 100.00)
Check box if you have a Co-Applicant :
Co-Applicant First Name : * Please enter Co-Applicant First Name Please enter letters only
Co-Applicant Last Name : * Please enter Co-Applicant Last Name Please enter letters only
Co-Applicant Date of Birth : * Please enter Co-Applicant Date of Birth
Co-Applicant Social Security Number : * Please enter Co-Applicant full Social Security Number Please enter exactly 9 digits (digits only)
Co-Applicant House Number / Building Number : * Please enter Co-Applicant House or Building Number
Co-Applicant Street Name : * Please enter the name of Co-Applicant street
Co-Applicant Apartment / Suite Number :
Co-Applicant City : * Please enter the city where Co-Applicant lives Please enter a valid city
Co-Applicant State : Please select State ALABAMA ALASKA ARIZONA ARKANSAS CALIFORNIA COLORADO CONNECTICUT DELAWARE DISTRICT OF COLUMBIA FLORIDA GEORGIA HAWAII IDAHO ILLINOIS INDIANA IOWA KANSAS KENTUCKY LOUISIANA MAINE MARYLAND MASSACHUSETTS MICHIGAN MINNESOTA MISSISSIPPI MISSOURI MONTANA NEBRASKA NEVADA NEW HAMPSHIRE NEW JERSEY NEW MEXICO NEW YORK NORTH CAROLINA NORTH DAKOTA OHIO OKLAHOMA OREGON PENNSYLVANIA RHODE ISLAND SOUTH CAROLINA SOUTH DAKOTA TENNESSEE TEXAS UTAH VERMONT VIRGINIA WASHINGTON WEST VIRGINIA WISCONSIN WYOMING AA - MILITARY AMERICAS AE - MILITARY EUROPE AP - MILITARY PACIFIC AMERICAN SAMOA FEDERATED STATES OF MICRONESIA GUAM MARSHALL ISLANDS NORTHERN MARIANA ISLANDS PALAU PUERTO RICO VIRGIN ISLANDS ALBERTA BRITISH COLUMBIA MANITOBA NEW BRUNSWICK NEWFOUNDLAND NORTHWEST TERRITORIES NOVA SCOTIA NUNAVUT ONTARIO PRINCE EDWARD ISLAND QUEBEC SASKATCHEWAN YUKON TERRITORY UNKNOWN STATE * Please select the State where Co-Applicant lives
Co-Applicant Zip Code : * Please enter the zip code where Co-Applicant lives Please enter exactly 5 digits (digits only)
Co-Applicant Cell Phone : * Please enter the cell phone number of Co-Applicant Please enter exactly 10 digits (digits only)
Co-Applicant Current Employer or Branch of Service : * Please enter the name of Co-Applicant current employer Please enter a valid name for Co-Applicant current employer
Co-Applicant Employer Address or Military Unit : * Please enter the address of Co-Applicant current employer Please enter a valid address for Co-Applicant current employer
Co-Applicant Hire Date : * Please enter Co-Applicant Hire Date
Co-Applicant Position or Rank : * Please enter Co-Applicant position or rank Please enter a valid position or rank
Co-Applicant Type of Business : * Please enter the type of business Co-Applicant works for Please enter a valid business type
Co-Applicant Monthly Net Income : $ * Please enter Co-Applicant monthly net income Must be in a valid monetary format (e.g. 100.00)
Co-Applicant Other Income : $ Must be in a valid monetary format (e.g. 100.00)
Source of Co-Applicant Other Income : Please enter a valid Other Income source
Certification: By selecting the Submit Application button below I certify that everything I have stated in this application is correct to the best of my knowledge. I understand that you will keep this application whether or not it is approved. I authorize you to check my credit and employment history through consumer reporting agencies, employers and other sources. I understand that the FSNB Checking account number I have provided will be assessed a $10.00 loan application fee at the time this application is submitted.