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CNB Loan Application

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 may also ask to see your driver's license or other identifying documents.

Important: Check the appropriate boxes below and complete the applicable sections.

Type of Credit Requested(*)

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Type of Credit Requested - Additional(*)

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Want to Repay(*)

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Amount Requested(*)
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$

For How Long?(*)
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Payment Date Desired(*)
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Proceeds of loan to be used for(*)
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Collateral (If applicable)
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Purchase Price
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Or Collateral Value
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Application Information

First Name(*)
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Middle Name
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Last Name(*)
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Email Address(*)
Invalid Input

Birth Date(*)
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Present Mailing Address(*)
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City(*)
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State(*)
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Zip Code(*)
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How long at this address?(*)
Invalid Input

Years

Home Phone Number(*)
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Ex: 555-555-5555

Physical Address
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If different than above

Previous Address(*)
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How Long at Previous Address?(*)
Invalid Input

Years

Select One(*)

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Monthy Housing Payment or Rent(*)
Invalid Input

$

Mortgage Balance
Invalid Input

$

Name and Address of Mortgage Holder / Landlord of Primary Residence(*)
Invalid Input

Social Security Number(*)
Invalid Input

Driver's License #
Invalid Input

If new customer

Drivers License Issuing State
Invalid Input

Drivers License Expiration Date
Invalid Input

MM/DD/YYYY

Employer(*)
Invalid Input

Position(*)
Invalid Input

Monthly Gross Salary(*)
Invalid Input

$

How Long?(*)
Invalid Input

Years

Employer Address(*)
Invalid Input

Employer Phone Number(*)
Invalid Input

Ex: 555-555-5555

Previous Employer
Invalid Input

Previous Employer Address
Invalid Input

How long at previous employer?
Invalid Input

Years

Name, Address & Telephone of nearest relative not living with you(*)
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Other Income

Note: Alimony, child support, or separate maintenance income need not be revealed if you do not wish to have it considered for repaying this obligation.

Source
Invalid Input

Amount per (wk., mo. or yr.)
Invalid Input

$

Source
Invalid Input

Amount per (wk., mo. or yr.)
Invalid Input

$


Obligations

Note: Please indicate of you are paying off a loan with this loan. Include any amounts you must pay toward alimony, child support or separate maintenance. Please list all credit obligations. Failure to list all outstanding debts may disqualify this application.

Creditor's Name
Invalid Input

Balance
Invalid Input

$

Monthly Payment
Invalid Input

$

Creditor's Name
Invalid Input

Balance
Invalid Input

$

Monthly Payment
Invalid Input

$

Creditor's Name
Invalid Input

Balance
Invalid Input

$

Monthly Payment
Invalid Input

$

Creditor's Name
Invalid Input

Balance
Invalid Input

$

Monthly Payment
Invalid Input

$


Deposit Information

 

Co-Applicant Information

First Name
Invalid Input

Middle Name
Invalid Input

Last Name
Invalid Input

Email Address
Invalid Input

Birth Date
Invalid Input

Present Mailing Address
Invalid Input

City
Invalid Input

State
Invalid Input

Zip Code
Invalid Input

How long at this address?
Invalid Input

Years

Home Phone Number
Invalid Input

Ex: 555-555-5555

Physical Address
Invalid Input

If different than above

Previous Address
Invalid Input

How Long at Previous Address?
Invalid Input

Years

Select One

Invalid Input

Monthy Housing Payment or Rent
Invalid Input

$

Mortgage Balance
Invalid Input

$

Name and Address of Mortgage Holder / Landlord of Primary Residence
Invalid Input

Social Security Number
Invalid Input

Driver's License #
Invalid Input

If new customer

Drivers License Issuing State
Invalid Input

Drivers License Expiration Date
Invalid Input

MM/DD/YYYY

Employer
Invalid Input

Position
Invalid Input

Monthly Gross Salary
Invalid Input

$

How Long?
Invalid Input

Years

Employer Address
Invalid Input

Employer Phone Number
Invalid Input

Ex: 555-555-5555

Previous Employer
Invalid Input

Previous Employer Address
Invalid Input

How long at previous employer?
Invalid Input

Years

Name, Address & Telephone of nearest relative not living with you
Invalid Input


Co-Applicant Other Income

Note: Alimony, child support, or separate maintenance income need not be revealed if you do not wish to have it considered for repaying this obligation.

Source
Invalid Input

Amount per (wk., mo. or yr.)
Invalid Input

$

Source
Invalid Input

Amount per (wk., mo. or yr.)
Invalid Input

$


Co-Applicant Obligations

Note: Please indicate of you are paying off a loan with this loan. Include any amounts you must pay toward alimony, child support or separate maintenance. Please list all credit obligations. Failure to list all outstanding debts may disqualify this application.

Creditor's Name
Invalid Input

Balance
Invalid Input

$

Monthly Payment
Invalid Input

$

Creditor's Name
Invalid Input

Balance
Invalid Input

$

Monthly Payment
Invalid Input

$

Creditor's Name
Invalid Input

Balance
Invalid Input

$

Monthly Payment
Invalid Input

$

Creditor's Name
Invalid Input

Balance
Invalid Input

$

Monthly Payment
Invalid Input

$


Co-Applicant Deposit Information

 

Privacy Policy

In order to continue with this loan application, please review our privacy policy:

(*)
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I/we hereby apply for the loan or credit described in this application. I/we certify that I/we made no misrepresentations in this loan application 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. The Lender is authorized to verify with other parties and to make any investigation of my/our credit and employment status, either directly or through any agency employed by the Lender for that purpose. Additionally, the Lender may obtain any credit reports that the Lender deems necessary or desirable in connection with the matters set forth herein and the Lender may obtain additional credit reports in connection with this transaction or extension of credit for the purpose of reviewing the account, increasing the credit line or amount of the account, for the purpose of taking collection actions on this account, or for any legitimate purposes associated with this account. It is my/our intent to hereby grant to the Lender permission to obtain credit reports to the full extent permitted by the Vermont Fair Credit Reporting Act, 9 V.S.A. Section 2480a-2480g. The Lender may disclose to any other interested parties information as to the Lender’s experiences or transactions with my account. I/we understand that the Lender will retain this application and any other credit information the Lender receives, even if no loan or credit is granted. These representations and authorizations extend not only to the Lender, but also to any insurer of the loan and to any investor to whom the Lender may sell all or any part of the loan. I/we further authorize the Lender to provide to any such insurer or investor any information or documentation that they may request with respect to my application, credit or loan.

Consumer Protection Disclosure: Sale of Insurance Products

I/we are applying for an extension of credit with Community National Bank. In connection with the application for credit, the Bank may be soliciting, offering or selling me an insurance product which requires the following disclosures:

FEDERAL LAW PROHIBITS COMMUNITY NATIONAL BANK FROM CONDITIONING THE EXTENSION OF CREDIT TO EITHER, 1.) My purchase of an insurance product from the Bank or any of our affiliates, or 2.) My agreement not to obtain, or a prohibition on me from obtaining, an insurance product from an unaffiliated entity.

  • The Product(s) are NOT DEPOSIT ACCOUNTS OR OTHER OBLIGATIONS of any depository institution or any affiliate of a depository institution.
  • The Product(s) are NOT GUARANTEED OR INSURED by any depository institution or any affiliate of any depository institution.
  • The Products(s) are NOT INSURED by the Federal Deposit Insurance Corporation, (FDIC) or any other federal governmental agency.

By clicking the submit button, I/we have read, understand and accept the terms of CNB's Privacy Policy. I/we have read, understand and agree to the Consent to Credit Statement. I/we acknowledge that I/we have read a copy of the Consumer Protection Disclosure for the Sale of Insurance Products.

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Applicant Initials(*)
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Co Applicant Initials
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Please review your information carefully.

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Preview of your Data


CNB Loan Application

Type of Credit Requested: .

Type of Credit Requested - Additional: .

Want to Repay: .

Amount Requested: .

For How Long?: .

Payment Date Desired: .

Proceeds of loan to be used for: .

Collateral (if applicable): .

Purchase Price: .

Or Collateral Value: .

Application Information

First Name: .

Middle Name: .

Last Name: .

Email Address: .

Birth Date: .

Present Mailing Address: .

City: .

State: .

Zip Code: .

How Long at this Address?: .

Home Phone Number: .

Physical Address (If different than above): .

Previous Address: .

How Long at Previous Address?: .

Own or Rent?: .

Monthly Housing Payment or Rent: .

Mortgage Balance: .

Name and Address of Mortgage Holder / Landlord of Primary Residence: .

Social Security Number: .

Driver's License # (If new customer): .

Drivers License Issuing State: .

Drivers License Expiration Date: .

Employer: .

Position: .

Monthly Gross Salary: .

How Long?: .

Employer Address: .

Employer Phone Number: .

Previous Employer: .

Previous Employer Address: .

How Long at Previous Employer?: .

Name, Address & Telephone of nearest relative not living with you: .

Other Income

Source: .

Amount per (wk., mo. or yr.): .

Source: .

Amount per (wk., mo. or yr.): .

Obligations

Creditor's Name: .

Balance: .

Monthly Payment: .

Creditor's Name: .

Balance: .

Monthly Payment: .

Creditor's Name: .

Balance: .

Monthly Payment: .

Creditor's Name: .

Balance: .

Monthly Payment: .

Deposit Information

Checking Account - Bank: .

Checking Account - Balance: .

Savings Account - Bank: .

Savings Account - Balance: .

Co-Applicant Information

First Name: .

Middle Name: .

Last Name: .

Email Address: .

Birth Date: .

Present Mailing Address: .

City: .

State: .

Zip Code: .

How Long at this Address?: .

Home Phone Number: .

Physical Address (If different than above): .

Previous Address: .

How Long at Previous Address?: .

Own or Rent?: .

Monthly Housing Payment or Rent: .

Mortgage Balance: .

Name and Address of Mortgage Holder / Landlord of Primary Residence: .

Social Security Number: .

Driver's License # (If new customer): .

Drivers License Issuing State: .

Drivers License Expiration Date: .

Employer: .

Position: .

Monthly Gross Salary: .

How Long?: .

Employer Address: .

Employer Phone Number: .

Previous Employer: .

Previous Employer Address: .

How Long at Previous Employer?: .

Name, Address & Telephone of nearest relative not living with you: .

Other Income

Source: .

Amount per (wk., mo. or yr.): .

Source: .

Amount per (wk., mo. or yr.): .

Obligations

Creditor's Name: .

Balance: .

Monthly Payment: .

Creditor's Name: .

Balance: .

Monthly Payment: .

Creditor's Name: .

Balance: .

Monthly Payment: .

Creditor's Name: .

Balance: .

Monthly Payment: .

Deposit Information

Checking Account - Bank: .

Checking Account - Balance: .

Savings Account - Bank: .

Savings Account - Balance: .

Other Information

Joint Credit: .

Applicant Initials: .

Co-Applicant Initials: .