Please fill out the fields in the form below. One of our lenders will contact you within one business day. In order to finalize this process you will be asked to present your photo ID and sign all necessary documents in person.

If you are applying for a First Lien Mortgage please click here http://www.ohnwardhomeloans.com/
* = Required field

WE INTEND TO APPLY FOR JOINT CREDIT:

Section A - Applicant Information
Do not complete this if this is an Application for an unsecured individual account.

Employment Information

Or

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.

YesNo
Obligated to pay alimony, child support, or separate maintenance?
Are you a co-maker or endorser on any loan or contract?
Are there any unsatisfied judgements against you?
Have you been declared bankrupt in the last 10 years?
Have you previously received credit from us?
Are you a US citizen?

Nearest Relative Not Living With You

Section B - Joint Applicant/Co-Applicant Information
Do not complete this if this is an Application for an unsecured individual account.

Employment Information

Or

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.

YesNo
Obligated to pay alimony, child support, or separate maintenance?
Are you a co-maker or endorser on any loan or contract?
Are there any unsatisfied judgements against you?
Have you been declared bankrupt in the last 10 years?
Have you previously received credit from us?
Are you a US citizen?
Section C - Assets and Debts

Assets

Use this form to input information about your creditors

Section D - Additional Information

Contact Information

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. What this means for you: When you open an account, 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.

If you are applying with First Central State Bank or Ohnward Bank & Trust, and your loan will be secured by a dwelling, please read and complete the following.

If you are applying with Gateway State Bank or Maquoketa State Bank; and your loan will be secured by your primary residence; and your loan proceeds will purchase or refinance your home; please read and complete the following.

Government Monitoring

REQUEST FOR DEMOGRAPHIC INFORMATION OF BORROWER

The purpose of collecting this information is to help ensure that all applicants are treated fairly and that the housing needs of communities and neighborhoods are being fulfilled. For residential mortgage lending, federal law requires that we ask applicants for their demographic information (ethnicity, race, and sex) in order to monitor our compliance with equal credit opportunity, fair housing, and home mortgage disclosure laws. You are not required to provide this information, but are encouraged to do so. The law provides that we may not discriminate on the basis of this information, or on whether you choose to provide it. However, if you choose not to provide the information and you have made this application in person, federal regulations require us to note your ethnicity, race, and sex on the basis of visual observation or surname. The law also provides that we may not discriminate on the basis of age or marital status information you provide in this application.

Instructions: You may select one or more “Hispanic or Latino” origins and one or more designations for “Race.” If you do not wish to provide some or all of this information, select the applicable box.

Applicant

Co-Applicant

Ethnicity - Applicant
Examples: Argentinean, Columbian, Dominican, Nicaraguan, Salvadoran, Spaniard, etc.
Ethnicity - Co-Applicant
Examples: Argentinean, Columbian, Dominican, Nicaraguan, Salvadoran, Spaniard, etc.
Race - Applicant
Enter Name of enrolled or principal tribe
Examples: Hmong, Laotian, Thai, Pakistani, Cambodian, etc.
Examples: Fijian, Tongan, etc.
Race - Co-Applicant
Enter Name of enrolled or principal tribe
Examples: Hmong, Laotian, Thai, Pakistani, Cambodian, etc.
Examples: Fijian, Tongan, etc.

Credit Authorization *

Gateway State Bank and First Central State Bank have shared common ownership for over 20 years. Now, the banks have combined, with Gateway adopting the First Central State Bank name. Thank you for trusting Gateway State Bank and we look forward to helping you achieve your financial goals at First Central State Bank.

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For assistance Contact Us at 888.242.4282

Pay It Ohnward

We commend our employees for sharing their hearts, time and compassion with our neighbors, family, friends,
and customers. Total overall Pay it Ohnward contributions will top $28,000 this year alone!