Loan App

Loan Application

* Required Field

Applicant must be a resident of Kansas, Missouri or Oklahoma and a U.S. Citizen, or permanent U.S. resident to qualify for this Internet offer.

Please provide all the requested information. When you have completed the form, press the “submit application” button to send your application. For questions, you may contact us at: 1-800-658-1637 ext. 7771.

IMPORTANT INFORMATION ABOUT PROCEDURES FOR OPENING A NEW ACCOUNT

To help the government fight the funding of terrorism and money laundering activities, the USA Patriot Act requires all financial institutions to obtain, verify and record information that identifies each person who opens an account or takes out a loan. What this means for you: When you open an account with our bank, we will ask for your name, physical address, date of birth, taxpayer identification number and other information that will allow us to identify you. We may also ask to see your driver’s license or other identifying documents. We will let you know if additional information is required.

Credit Request
Credit Type
We intend to apply for joint credit.
Applicant
Marital Status
Residence Status
Current Residence Status
Have You Lived at Your Current Address Less Than Two Years?
Employment Status
Salary Type
Have You Been Employed at Your Current Employer Less Than Two Years?
Do You Want to List Other 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.

Other Information
Do You Pay Child Support or Alimony?
Have You Been Declared Bankrupt in the Last Ten Years?
Are You a Co-maker, Endorser or Guarantor on Any Loan or Contract?
Debt Information
Co-applicant
Marital Status
Residence Status
Current Residence Status
Have You Lived at Your Current Address Less Than Two Years?
Employment Status
Salary Type
Have You Been Employed at Your Current Employer Less Than Two Years?
Do You Want to List Other 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.

Other Information
Do You Pay Child Support or Alimony?
Have You Been Declared Bankrupt in the Last Ten Years?
Are You a Co-maker, Endorser or Guarantor on Any Loan or Contract?
Debt Information

Notice

By completing and submitting this loan application, you certify that the information in it is correct and you authorize Fidelity Bank | Oklahoma Fidelity Bank to verify such information, to obtain credit reports, to verify any other credit references, and to make such other investigations as Fidelity Bank | Oklahoma Fidelity Bank deems appropriate. You agree to promptly notify Fidelity Bank of any adverse change in your financial condition. This application does not constitute a contract for the extension of credit. Sec. 1014, Title 13, U.S. Code, makes it a Federal Crime to knowingly make a false statement on this application.

HMDA REQUIREMENTS

The following information is requested by the federal government for certain types of loans related to 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. (Lender must review the requested material to assure that the disclosures satisfy all requirements to which the lender is subject under applicable state law for the particular type of loan applied for.)

Applicant
Ethnicity
Do you wish to furnish the following information?
Hispanic or Latino
Race
Do you wish to furnish the following information?
American Indian or Alaska Native
Native Hawaiian or Other Pacific Islander
Asian
White
Black or African American
Sex
Do you wish to furnish the following information?
Sex
Co-applicant
Ethnicity
Do you wish to furnish the following information?
Hispanic or Latino
Race
Do you wish to furnish the following information?
American Indian or Alaska Native
Native Hawaiian or Other Pacific Islander
Asian
White
Black or African American
Sex
Do you wish to furnish the following information?
Sex

INSURANCE DISCLOSURE

In connection with your loan application, the Bank may solicit, offer, or sell an insurance product to you. The Bank cannot, as a condition of extending credit to you: (i) require that you purchase an insurance product from the Bank, or (ii) require your agreement not to obtain, or prohibit you form obtaining an insurance product from an unaffiliated entity.