Personal Loan Account Application

Thank you for your interest in Jonestown Bank & Trust Co.  Part of our mission, as a community bank, is to provide the best possible service to our customers. To meet this goal we limit on-line applications to existing customers and other residents of our geographic area.

Our primary service area is Lebanon County, Pennsylvania. Our secondary service area is Western Berks, Southern Schuylkill, Eastern Dauphin, and Northern Lancaster Counties, Pennsylvania. If you are not a current JBT customer or a resident of these areas, we may deny your loan application solely based on that fact.

We invite you to submit this application by completing the form below and clicking on the "Submit" button at the end of the form. If your loan application is approved, we will require that you visit one of our offices to sign the necessary loan documents. Please select the branch office that would be most convenient for you.

If you have any questions about our products or need further assistance, please email us at eservice@bankjbt.com.   Warning:  email is not secure; do not send sensitive information by way of this link.

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, AND DATE OF BIRTH, SOCIAL SECURITY 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.

 

Choose a loan type:

Marital Status: Do NOT complete if this is an application for individual unsecured credit.

 

Step 1 – Personal Information

 

 

First Name

 

MI

 

Last Name

 

 

 

 

 

 

 

Social Security Number

 

 

 

Date of Birth (MM/DD/YYYY)

- -

 

 

 

/ /
(Must be at least 18 years of age.)

 

 

 

 

 

Home Phone

 

 

 

E-mail Address

() -

 

 

 

 

 

 

 

 

Drivers License Number (or Registered ID)

 

 

 

State

 

 

 

 

 

 

 

 

Issued (MM/DD/YYYY)

 

 

 

Expires (MM/DD/YYYY)

/ /

 

 

 

/ /

 

 

 

 

 

Employer Name

 

Employer Address

 

 

 

 

Employer Phone Number

 

Occupation

 

How Long?

 

 

() - ext.

 

 

Years

Months

 

Previous Employer

 

Previous Employer Address

 

 

 

 

Previous Employer Phone Number

 

Occupation

 

How Long?

 

 

() - ext.

 

 

Years

Months

 

Step 2 – Address Information

 

 

Residential Address
(We cannot accept PO Box #s)

 

Own

 

How Long?

 

 

 

Rent

 

Years

Months

 

 

 

 

 

City

 

State

 

Zip Code

 

 

 

 

 

 

 

Mailing Address (if different from above)

 

 

 

 

 

City

 

State

 

Zip Code

 

 

 

 

 

 

 

Previous Address
(We cannot accept PO Box #s)

 

 

 

How Long?

 

 

 

 

 

Years

Months

 

 

 

 

 

City

 

State

 

Zip Code

 

 

 

Step 3 – Co Applicant Information

 

 

Complete the following information if you have a Co-Applicant. If no Co-Applicant, skip to Step 4.

Relationship to Applicant, if any

 

Marital Status

 

 

First Name

 

MI

 

Last Name

 

 

 

 

 

 

 

Social Security Number

 

 

 

Date of Birth (MM/DD/YYYY)

- -

 

 

 

/ /
(Must be at least 18 years of age.)

 

 

 

 

 

Home Phone

 

 

 

E-mail Address

() -

 

 

 

 

 

 

 

 

Drivers License Number (or Registered ID)

 

 

 

State

 

 

 

 

 

 

 

 

Issued (MM/DD/YYYY)

 

 

 

Expires (MM/DD/YYYY)

/ /

 

 

 

/ /

 

Residential Address
(We cannot accept PO Box #s)

 

Own

 

How Long?

 

 

 

Rent

 

Years

Months

 

 

 

 

 

City

 

State

 

Zip Code

 

 

 

Employer Name

 

Employer Address

 

 

 

 

Employer Phone Number

 

Occupation

 

How Long?

 

 

() - ext.

 

 

Years

Months

 

Previous Employer

 

Previous Employer Address

 

 

 

 

Previous Employer Phone Number

 

Occupation

 

How Long?

 

 

() - ext.

 

 

Years

Months

 

 Step 4 Income Information

 

 

 

 

Applicant

 

Co-Applicant

 

 

 

 

 

Gross Monthly Income

 

 

 

 

Salary

 

$

 

$

 

 

 

 

 

Commissions/Bonuses

 

$

 

$

 

 

 

 

 

Tips

 

$

 

$

 

 

 

 

 

Overtime

 

$

 

$

 

 

 

 

 

Social Security

 

$

 

$

 

 

 

 

 

Retirement

 

$

 

$

 

 

 

 

 

IMPORTANT: 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 loan.

 

 

 

 

 

 

 

Applicant

 

Co-Applicant

 

 

 

 

 

Other Income

 

$

 

$

 

 

 

 

 

Source

 

 

 

Step 5 – Loan Information

 

 

Requested Loan Amount

 

Requested Term

 

Purpose

$

 

 

 

Collateral, if any

 

 

 

 

 

 

New Vehicle

 

Used Vehicle

 

 

 

Year

 

Make

 

Model

 

Other Collateral, i.e., certificate of deposit

 

Credit References
Mortgagee/Landlord

 

Name(s) on Loan/Credit

 

Payment

 

Balance

 

Applicant

 

Co-Applicant

 

$

 

$

 

 

 

 

 

 

 

 

 

Other Creditors

 

 

 

 

 

 

 

 

 

Applicant

 

Co-Applicant

 

$

 

$

 

 

 

 

 

 

 

 

 

 

Applicant

 

Co-Applicant

 

$

 

$

 

 

 

 

 

 

 

 

 

 

Applicant

 

Co-Applicant

 

$

 

$

 

 

 

 

 

 

 

 

 

 

Applicant

 

Co-Applicant

 

$

 

$

 

 

 

 

 

 

 

 

 

 

Applicant

 

Co-Applicant

 

$

 

$

 

 

 

 

 

 

 

 

 

 

Applicant

 

Co-Applicant

 

$

 

$

 

Personal Reference (Name and address of nearest relative not living with you)

First Name

 

Middle Initial

 

Last Name

 

 

 

 

 

 

 

Home Phone

 

 

 

Relationship

() -

 

 

 

 

 

 

 

 

Residential Address
(We cannot accept PO Box #s)

 

 

 

How Long?

 

 

 

 

 

Years

Months

 

 

 

 

 

City

 

State

 

Zip

 

 

 

Declarations

Applicant

Co-Applicant

Are there any judgments outstanding against you?

 

 

 

Have you been declared bankrupt in the past seven years?

 

 

 

Are you a cosigner or co maker, endorser, or guarantor on any loan?

 

 

 

Comments - Provide additional information or explanations relevant to your request for a loan.

Step 6 - Acknowledgement

 

 

By submitting this loan application, I certify that everything I have stated in this application is correct. You may keep this application whether or not it is approved. I authorize you to check my credit and employment history, to obtain a consumer credit report in connection with this application, and to answer questions others may ask about my credit record with you. I understand that I must update credit information at your request if my financial condition changes. I further warrant that I am at least 18 years of age and a U.S. resident.

 

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OR

If you desire, this form may be printed and mailed to us at the address below.

Please print this form using the "PRINT" button below, sign it, and mail it to us at:

_____________________________________________ Signature

_____________________________________________ Co-applicant Signature (if applicable)

Jonestown Bank & Trust Co.
ATTN: Internet Banking Services
421 E. Penn Avenue
Cleona, PA 17042