Short Loan Application The Harvard State Bank

Getting Started Online

Welcome to our secure online pre-qualification form.

Borrower Information

First Name

M.I.

Last Name

Date of Birth

Street

City

State

Zip

Home Phone

Business Phone

Mobile/Page/Alternate

Fax

Email Address

Contact Me at

Best Time to Call

Total Gross Yearly Income (Income Before Taxes)
*$
*Self Employed Borrower(s) may be required to provide additional documentation such as tax returns and financial statements.

Notice: Alimony, child support, or separate maintenance income need not be revealed if the Borrower(B) or Co- Borrower(C) does not choose to have it considered for repaying this loan.

Current Employer

Number of Years

Co-Borrower Information

Will there be a co-borrower on this loan?
No co-borrowerSpouseOther

First Name

M.I.

Last Name

Date of Birth

Referral Information
Referred by

Loan Originator

If you would like to work with a specific loan originator, please select the name above.

Loan Information

Loan Purpose

Property Type

Purchase Price
$

Amt Avail for Down Payment on Closing Costs
$

Your Message

Online Banking

Short Loan Application

Getting Started Online