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Oregon Pacific Bank
Internet Loan Application
policy protects the privacy of your personal
identifying information that you provide us online.
Applicants must reside in State of Oregon.
Important Information about Procedures for Opening a New
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 identifying
You should ONLY fill out this loan application online
if you are using a browser with the latest security
enhancements. If you do not 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 will need.
2. Complete application online and click "Submit
Application" or fax it to (541) 997-2774.
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
Co-Applicant Home Information
Co-Applicant Additional Information
This Section for AUTO LOAN Applicants
I/We have completed this request for credit in
consideration of Oregon Pacific Bank 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 Oregon Pacific Bank 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 Oregon Pacific Bank at any time. I
acknowledge that this application is subject to approval
of credit and acceptance by Oregon Pacific Bank.
Should my request for credit and subsequent loan be
approved, I agree to give Oregon Pacific Bank
written notice immediately upon change of my name,
address, employment or any other pertinent information