Applicants must reside in Miller or Morgan Counties, Missouri or the surrounding communities.
Important Information about Procedures for Opening a New Account
Identification Procedures Requirements: 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, date of birth, and other information that will allow us to
identify you. We may also ask to see your driver's license or other
You should ONLY fill out this form on-line if you are using a browser with the latest security enhancements. If you don't have the latest version, download a copy now. This form is NOT cached (saved in your computer's memory) when you QUIT your browser.
1. Print this loan application and gather the information you'll need.
2. Complete application on-line and click "Submit Application" or fax it to 573-392-7786.
3. To safeguard your privacy, QUIT your browser and restart it again after using this form.
This loan application is for personal loans only and is NOT intended for commercial use. A valid social security number is required to apply. Please review and gather the information you will need before completing this form. Upon receipt of the application, we will send you the proper disclosures.
Co-Applicant Home Information
Co-Applicant Additional Information
I/We have completed this request for credit in consideration of Citizens Bank of Eldon & Versailles lending to me and/or others upon my guarantee. I/We certify that all information contained herein is accurate and complete to the best of my knowledge.
I/We authorize Citizens Bank of Eldon & Versailles to retain property of this application, to rely on the foregoing, to check and verify my credit, employment and salary history, to secure follow up credit reports concerning my credit worthiness and to exchange information about my account with proper persons, creditors and credit bureaus.
I authorize my employer (present and future), bank and other references listed above to release and/or verify information to Citizens Bank of Eldon & Versailles at any time. I acknowledge that this application is subject to approval of credit and acceptance by Citizens Bank of Eldon & Versailles. Should my request for credit and subsequent loan be approved, I agree to give Citizens Bank of Eldon & Versailles written notice immediately upon change of my name, address, employment or any other pertinent information contained herein.