Secure Online Banking


Enroll Now

News

  • FPB Announces 7th Annual John L. McGee Scholarship...Read more
  • Florida Parishes Bank Officially Opens New Mandeville Branch...Read more
     

Home Loan

Florida Parishes Bank Secure Loan Application
Florida Parishes Bank applications are private and secure.

The following form is an abbreviated residential loan application designed to provide us with the basic information we may need to prequalify you for a home mortgage. Please provide all of the requested information. When you have completed the form, press the submit button to send your application. We will then contact you for pre-qualification and assist you with the process of obtaining a loan.

The items marked with (*) are required fields.


General Information

Will you be applying for Individual or Joint Credit?
Joint
Individual

(If Joint, the co-applicant section has the same required fields as the primary applicant.)

Marital Status: Complete marital status if this loan is for:

a. Joint or secured credit, or
b. You reside in or rely on property located in a Community Property State. (AZ, CA, ID, LA, NM, NV, TX, WA, WI)
Unmarried
Married
Separated
This application is not for joint or secured credit and I do not live in the states listed above.

*Type of Loan Requested

*Loan Amount Requested

$

*Loan Term Requested

*Interest Rate Requested

Back to Top | Jump to Submit


Primary Applicant

*Do you have an account with us?

Yes No
*Last Name
*First Name
Middle Name
*Social Security Number (TIN) --
*Date of Birth //
Number of Dependents
Ages of Dependents
*Home Phone Number --
Work Phone Number - - ext.
Number - -ext.
Email Address
Drivers License #
Drivers License State

Home Address

*Address 1
Address 2
*City
*State *Zip -
Time at Current Residence
Years Months
Residence Type Own Rent Other

Previous Address

Address 1
Address 2
City
State Zip -
Time at Previous Residence
Years Months
Residence Type: Own Rent Other

Present Employer

Name
Phone Number - - ext.
Employment Status
Full Time
Part Time
Temp
Retired
Other
Job Title
Job Start Date //
Gross Salary
$ Per

Alimony, child support, or separate maintenance need not be revealed if you do not wish to have it considered as a basis for repaying obligation.

Other Income
$ Per
Other Income Source

Previous Employer

Name
Phone Number - - ext.
Employment Status
Full Time
Part Time
Temp
Retired
Other
Job Title
Job Start Date //
Job End Date //
Gross Salary $ Per

Back to Top | Jump to Submit


Co-Applicant

*Do you have an account with us?
Yes No
*Last Name
*First Name
Middle Name
*Social Security Number (TIN) --
*Date of Birth /
Number of Dependents
Ages of Dependents
*Home Phone Number --
Work Phone Number -- ext.
Number - -ext.
Email Address
Drivers License #
Drivers License State

Home Address

*Address 1
Address 2
*City
*State *Zip
Time at Current Residence
Years Months
Residence Type
Own Rent Other
Monthly Payment
$

Previous Address

Address 1
Address 2
City
State
Zip -
Time at Previous Residence
Years Months
Residence Type Own Rent Other

Present Employer

Name
Phone Number -- ext.
Employment Status Full Time Part Time Temp Retired Other
Job Title
Job Start Date //
Gross Salary $ Per

Alimony, child support, or separate maintenance need not be revealed if you do not wish to have it considered as a basis for repaying obligation.

Other Income $ Per
Other Income Source

Previous Employer

Name
Phone Number -- ext.
Employment Status
Full Time Part Time Temp Retired Other
Job Title
Job Start Date //
Job End Date //
Gross Salary $ Per

Back to Top | Jump to Submit


References

Nearest relative Not Living With You

Last Name
First Name
Relationship
Number -- ext.
Address 1
Address 2
City
State
Zip -

Back to Top | Jump to Submit


Credit and Asset Information

Monthly Obligations:

Installment Payments $
Revolving Payments $
Mortgage Payments/Rent $
Other Obligations $

Assets:

Liquid Assets (cash, savings, etc.) $
Stocks, Bonds, Mutual Funds, etc. $
Fixed Assets (Real Estate, personal property) $

Back to Top | Jump to Submit


Miscellaneous Property Information

If you have property picked out, this does not obligate you to buy.

Property Type:
Property Address 1:
Property Address 2:
Property City:
State:
Zip:
Annual Property Taxes: $
Annual Hazard Insurance: $
Annual Condo/PUD Fees: $

Back to top of page | Jump to Submit Button


Home Mortgage Disclosure Act (HMDA)

Please Note: The following information is requested by the federal government for certain types of loans related to a dwelling in order to monitor the lender' s compliance with equal credit opportunity, fair housing, and home mortgage disclosure laws. You are not required to furnish this information, but are encouraged to do so. You may select one or more designations for "Race. " The law provides that a lender may not discriminate on the basis of this information, or on whether you choose to furnish it. However, if you choose not to furnish the information and you have made this application in person, under federal regulations the lender is required to note ethnicity, race, and sex on the basis of visual observation or surname. If you do not wish to furnish the information, please check below.

Primary Applicant

I do not wish to furnish this information
Ethnicity Hispanic or Latino
Not Hispanic or Latino
Race American Indian, Alaskan Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White
Sex Male
Female

Co-Applicant (if applicable)

I do not wish to furnish this information
Ethnicity Hispanic or Latino
Not Hispanic or Latino
Race American Indian, Alaskan Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White
Sex Male
Female

Back to top of page | Jump to Submit Button


Additional Information

How would you prefer to be contacted?
Home Phone
Work Phone
Cell Phone
Email Address
Other
Please add me to your email list.
Special Instructions/Comments

Back to top of page | Jump to Submit Button


Please note: Income verification is required; other information may be required.

I certify that statements on this application are true and complete. I authorize any person, association, firm or corporation to furnish, on request of this financial institution, information concerning me or my affairs.(Sec. 1014, Title 18, U.S. Code makes it a Federal Crime to knowingly make a false statement on this application.)

Security Code (Not Case Sensitive)