Wells Federal Bank

Internet Installment Loan Application


53 First Street SW
PO Box 310
Wells, MN 56097
507-553-3151
800-944-5869
507-553-6908 fax

      

Loan Services are available throughout the bank's regular service area.
Contact the bank for specific information regarding this service area.

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You may not want to submit sensitive or private information via this form.

Which Branch Office?
Loan Type Year
New Used
Loan Amount Mileage  
Term Make  
Purpose
Model  
Purchase Price
Serial  
Down Payment
License #  

PART I

First Name

Middle Initial

Last Name

Social Security Number
Driver's License Number
Current Address
Previous Address (if less than 2 years)
Street Address
City
State
Zip
How Long
Date of Birth
Home or Nearby Phone
Employed By
Employer's Address
Position  
Salary
How Long with Employer
 
Last Employer (If employed less than 3 years)
Length 

Amount of other income

Sources of other income (you need not reveal alimony, child support or maintenance payments)

Bank Reference - Name of Bank

Type of Account
Status of account
List below all contracts or loans on which you are now making payments (include auto, furniture, home improvements, credit line, clothing, etc.)
Payments Made To
Address
Purpose
Unpaid Balance
Monthly Payment
Is this all you owe? (y/n)
Total of other indebtedness
Monthly Mortgage Payment
Value
Balance
Mortgage Holder
Monthly Rent Payment
Landlord
Address

PART II

Co-applicant: 
Co-applicant's address, if different from applicants 
Birthdate
Co-app's Employer
Position
How Long Employed
Co-applicant salary
Phone
Employer's Address
Social Security #

PART III

Comments
 
 

PART IV

By submitting this application electronically I authorize Wells Federal Bank to check my credit and employment history and to answer questions about your credit experience with me.
Equal Opportunity Lender
 
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