Home Loan Application

Loan Application

Apply for a new loan.

* = Required Field

Borrower

  •  

  • Please enter your previous address below if total is less than 2 years.


    Please enter your previous address below if total is less than 2 years.


    Please enter your previous address below if total is less than 2 years.

  •  
    • 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.

Co-Borrower

  •  

  • Please enter your previous address below if total is less than 2 years.


    Please enter your previous address below if total is less than 2 years.


    Please enter your previous address below if total is less than 2 years.

  •  
    • 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.

Type of Loan

  • 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. The law provides that a lender may not discriminate either on the basis of this information, or on whether you choose to furnish it. If you furnish the information, please provide both ethnicity and race. For race, you may check more than one designation. If you do not furnish ethnicity, race, or sex, under Federal regulations, this lender is required to note the information on the basis of visual observation and surname if you have made this application in person. If you do not wish to furnish the information, please check the box below. (Lender must review the above 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.)

Loan Origination Company’s Name: Raccoon Valley Bank
Loan Origination Company Identifier: 407837
Loan Origination Company's Address: 1202 Second St P.O. Box 129 Perry, IA 50220

Loan Originator's Name
Location
Loan Originator Identifier
Loan Originator's Phone Number
Douglas Zeigler
Adel
500948
515-993-4581
Thomas Book
Adel
500956
515-993-4581
Warren Poldberg
Adel
500951
515-993-4581
Thomas Heun
Bagley
500950
641-427-5234
Christopher Watkins
Dallas Center
1060726
515-992-9200
Randi Millsap
Dallas Center
879225
515-992-9200
Charles Painter
Perry
500952
515-465-3521
Daniel Rivera
Perry
500953
515-465-3521
Randy Allen
Perry
500956
515-465-3521

Branch Location

  

Credit Disclosures

An insurance product or annuity may be offered to you. If you purchase an insurance product or an annuity: (1) The insurance product or annuity is not a deposit or other obligation of, or guaranteed by, this institution or our affiliate(s); (2) With exception of Federal Flood Insurance or Federal Crop Insurance, the insurance product or annuity is not insured by the Federal Deposit Insurance Corporation or any other agency of the United States, this institution, or our affiliate(s); and (3) In the case of an insurance product or annuity that involves an investment risk, there is investment risk associated with the insurance product, including the possible loss of value. If an insurance product or annuity is offered we cannot condition an extension of credit on either of the following: (1) Your purchase of an insurance product or annuity from us or any of our affiliates; or, (2) Your agreement not to obtain, or a prohibition on you from obtaining, an insurance product or annuity from an unaffiliated entity.

By clicking Submit I certify that everything I have stated in this Application is correct to the best of my knowledge. I understand that you will retain this Application whether or not it is approved. You are authorized to check my credit and employment history and answer questions about your credit experience with me.