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Consumer Loan Application

Platte Valley Companies

Consumer Loan Application

Credit Application

Check the appropriate boxes and complete the applicable sections. Use 'NA' for blank fields.








YesNo

SecuredUnsecured

Description of Collateral:
















Section A

Individual Applicant Information




























OwnRent















NAOwnRent


























Other Income

Note: 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.


NACourt OrderWritten AgreementOral Understanding





NoYes



NoYes


Section B

Joint Applicant or Other Party Information. Complete only if: for joint credit, for individual credit relying on income or assets from other sources or applicant is married and resides in a community property state.











































Other Income

Note: 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.


NACourt OrderWritten AgreementOral Understanding





NoYes



NoYes


Section C

Marital Status Note: Complete only if for joint or secured credit, or applicant resides in a community property state or is relying on property located in such a state as a basis for repayment of the credit requested.


MarriedSeparatedUnmarried (including single, divorced or widowed)

NAMarriedSeparatedUnmarried (including single, divorced or widowed)

Section D

Complete the following information about both the Applicant and Joint Applicant or Other Person (if applicable).


NoYes





NoYes





NoYes





NoYes




Section E - Insurance

Platte Valley Bank - Nebraska, Wyoming (Lender) is hereby authorized to contact, discuss with and request from my/our Insurance Agency listed below as loss payee on insurance policies covering collateral pledged to Lender to secure indebtedness currently owed by me/us.







Section F - Bank Location

So we can better serve you, please select the Platte Valley Bank location that you bank at or the location nearest you.


NOTICE - Joint Intent


We intend to apply for joint credit (Signatures Required BelowI am applying for credit in my name only, and am relying only on my income/assets in my name only for repayment of this loan.








Signatures

I certify that everything I have stated in this application and on any attachments is correct. Lender may keep this application whether or not it is moved. By signing below I authorize Lender to check my credit and employment history and to answer questions others may ask Lender about my credit record with Lender. I understand that I must update credit information at Lender's request if my financial condition changes.









Consumer Credit Disclosure

This document is a written disclosure for the sale of insurance when Platte Valley Bank extends credit.





To Credit Applicant

Platte Valley Bank advised you we may not condition the extension of credit on the following:

-Your purchase of insurance from Platte Valley or any of its affiliates;


-Your agreement to not obtain insurance from an entity not affiliated with Platte Valley Bank.

In addition, Platte Valley Bank may not prohibit you from obtaining insurance from an entity not affiliated with us.

Please sign to acknowledge the written and verbal receipt of this disclosure:











PLATTE VALLEY COMPANIES IDENTITY VERIFICATION

THE USA PATRIOT ACT REQUIRES THAT WE OBTAIN IDENTITY VERIFICATION FROM YOU BEFORE ESTABLISHING YOUR ACCOUNT.

MINIMUM INFORMATION REQUIRED:

NAME;

DATE OF BIRTH (FOR INDIVIDUALS);

ADDRESS

FOR INDIVIDUALS

RESIDENCE AND, IF DIFFERENT, MAILING ADDRESS;

FOR PERSONS OTHER THAN INDIVIDUALS (SUCH AS CORPORATIONS, PARTNERSHIPS AND TRUSTS)

PRINCIPAL PLACE OF BUSINESS AND, IF DIFFERENT, MAILING ADDRESS;

IDENTIFICATION NUMBER

U.S. PERSON

TAXPAYER IDENTIFICATION NUMBER (e.g. SOCIAL SECURITY NUMBER, INDIVIDUAL TAXPAYER IDENTIFICATION NUMBER OR EMPLOYER IDENTIFICATION NUMBER);

NON-U.S. PERSON

ONE OR MORE OF THE FOLLOWING: A U.S. TAXPAYER IDENTIFICATION NUMBER, PASSPORT NUMBER AND COUNTRY OF ISSUANCE; ALIEN IDENTIFICATION CARD NUMBER; OR NUMBER AND COUNTRY OF ISSUANCE OF ANY OTHER GOVERNMENT ISSUED DOCUMENT EVIDENCING NATIONALITY OR RESIDENCE AND BEARING A PHOTOGRAPH OR SIMILAR SAFEGUARD.

ADDITIONAL INFORMATION

IDENTIFICATION SUCH AS AN UNEXPIRED DRIVER’S LICENSE WITH A PHOTOGRAPH, EXCEPT THAT IF YOU ARE DISABLED, ELDERLY, OR A YOUTH WITHOUT A PHOTO IDENTIFICATION CARD, IDENTITY MAY BE VERIFIED BY A SOCIAL SECURITY, MEDICARE, MEDICAID OR OTHER INSURANCE CARD ALONG WITH A SEPARATE DOCUMENT THAT SHOWS YOUR NAME AND ADDRESS. (EACH JOINT SIGNER ON AN ACCOUNT WILL BE REQUIRED TO PROVIDE THIS INFORMATION WITHIN 30 DAYS. FAILURE TO PROVIDE INFORMATION WITHIN THIS TIME FRAME WILL RESULT IN SIGNATORY REVOCATION ON THE ACCOUNT).

ENTITIES OTHER THAN INDIVIDUALS WILL BE REQUIRED TO PROVIDE DOCUMENTS SHOWING THE EXISTENCE OF THE ENTITY SUCH AS FINANCIAL STATEMENTS, REGISTERED ARTICLES OF INCORPORATION, PARTNERSHIP AGREEMENTS OR TRUST INSTRUMENTS. (ADDITIONAL “MINIMUM” INFORMATION MAY BE REQUESTED FROM INDIVIDUALS WITH AUTHORITY OR CONTROL OVER SUCH ACCOUNTS AS THE BANK DEEMS NECESSARY).

Dated: September 2003

 

 

 

GET THE MORTGAGE LOANS YOU NEED.

GET THE MORTGAGE LOANS YOU NEED.

Find your nearest Platte Valley Bank

Platte Valley Bank is pleased to offer a wide variety of accounts and services to meet the needs and lifestyles of all of our personal banking customers. Whether you need a checking account with no minimum balance requirement, a savings account with a competitive interest rate, or a personal loan to help you achieve your goals, we have a product to meet your needs.

Nebraska Main Bank

Scottsbluff Phone: 308-632-7004 Toll Free: 888-632-7004

Wyoming Main Bank

Torrington Phone: 307-532-2111 Toll Free: 800-777-8999

Regulatory Notices

Privacy Notice

Facebook Posts

We're Hiring! Platte Valley Bank in Casper, Wyoming is looking for a Personal Banker to join the team! For more information and to apply, visit pvbank.com/careers/ ... See MoreSee Less

Were Hiring! Platte Valley Bank in Casper, Wyoming is looking for a Personal Banker to join the team! For more information and to apply, visit https://pvbank.com/careers/

 

Comment on Facebook

Marcie Ramirez tell Jacob

We are a proud sponsor of the 2018 Old West Balloon Fest, which will be held Friday, August 17th and Saturday, August 18th. As a reminder, parking passes are required and are available at our Platte Valley Bank locations in Scottsbluff, Gering, Bridgeport and Morrill. The cost is $10 and is valid for the sunrise launch on Friday and Saturday morning and the Night Glow Saturday night. ... See MoreSee Less

 

Comment on Facebook

Have you chosen the winner of the hot air balloon ride?

Get your engines running for the Morrill Movie in the Park! Tonight is a free screening of "Cars" along with a Cardboard Car decoration contest and a prize pack with four tickets to Hiway 92 Raceway. Movie starts around 8:15 p.m. - be sure to be there early for all of the fun festivities. We can't wait to see everyone there! ... See MoreSee Less

Get your engines running for the Morrill Movie in the Park! Tonight is a free screening of Cars along with a Cardboard Car decoration contest and a prize pack with four tickets to Hiway 92 Raceway. Movie starts around 8:15 p.m. - be sure to be there early for all of the fun festivities. We cant wait to see everyone there!

We have had a blast so far this week at the Goshen County Fair in Torrington, Wyoming! ... See MoreSee Less

We've got bags full of candy to give out during the Goshen County Fair Parade on Torrington! We hope everyone has fun and safe weekend! Saving is Sweet with Platte Valley Bank! ... See MoreSee Less

Weve got bags full of candy to give out during the Goshen County Fair Parade on Torrington! We hope everyone has fun and safe weekend! Saving is Sweet with Platte Valley Bank!

1 week ago

Platte Valley Bank

Join us tonight in Morrill for our last movie of the summer season! Remember to bring your cardboard cars for our contest! ... See MoreSee Less

Join us tonight in Morrill for our last movie of the summer season! Remember to bring your cardboard cars for our contest!Image attachment

 

Comment on Facebook

Thank you for organizing these fun community events. We all had so much fun!

As a reminder, Platte Valley Bank in Torrington, WY will be closing early on Thursday, August 9th for the Goshen County Fair and Parade. ... See MoreSee Less

As a reminder, Platte Valley Bank in Torrington, WY will be closing early on Thursday, August 9th for the Goshen County Fair and Parade.

1 week ago

Platte Valley Bank

Members of their drumline battled it out with VIBES advanced drumline in front of a packed crowd at David Street Station in Casper, WY this afternoon. Check it out!

Boys & Girls Clubs of Central Wyoming
What a treat from the Denver Nuggets SkyLine!

Members of their drumline battled it out with VIBES advanced drumline in front of a packed crowd at David Street Station this afternoon.

The group then let Club youth make some of their own music on their drums and signed autographs.

Thanks to Platte Valley Bank for making this possible and for its support in music education and exploration for our children.
... See MoreSee Less

2 weeks ago

Platte Valley Bank

We are ready for the Platte County Fair parade in Wheatland, Wyoming! Special thanks to Wayne Paris for letting us use his fully restored Ford ZLazyY. We hope everyone enjoys the parade and fair! ... See MoreSee Less

We are ready for the Platte County Fair parade in Wheatland, Wyoming! Special thanks to Wayne Paris for letting us use his fully restored Ford ZLazyY.  We hope everyone enjoys the parade and fair!Image attachment

2 weeks ago

Platte Valley Bank

We are proud to be a sponsor for the Drumline Battle Event between the VIBES Drumline and the Denver Nuggets SkyLine Drumline! The free event will be held Monday, 8/6 from 12-1 p.m. at David Street Station in Casper, Wyoming. Stop by to cheer for your favorite drumline!

Vibes Fine & Performing Arts
Denver Nuggets SkyLine We're Calling YOU OUT....
LET'S MAKE SOME NOISE!
Drop us a BEAT in the comments below.
#Like for Nuggets #Share for VIBES
#DrumlineBattle #MakeSomeNoise
... See MoreSee Less

 

Comment on Facebook

Thank you so much Platte Valley Bank for making this opportunity possible for our students, families, and Casper community! This is going to be a once-in-a-lifetime experience!!

3 weeks ago

Platte Valley Bank

Great way to kick off Fair Week in Mitchell, NE! ... See MoreSee Less

Great way to kick off Fair Week in Mitchell, NE!

3 weeks ago

Platte Valley Bank

Platte Valley Bank associates (left to right) Bridget Peck, Amy Doll, Tim Propp and John Marshall teamed up for the Putt For The Paw golf tournament to support the Scottsbluff Booster Club. Thanks to all of the volunteers and golfers who helped make this event a success! ... See MoreSee Less

Platte Valley Bank associates (left to right) Bridget Peck, Amy Doll, Tim Propp and John Marshall teamed up for the Putt For The Paw golf tournament to support the Scottsbluff Booster Club. Thanks to all of the volunteers and golfers who helped make this event a success!
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Contact

Nebraska Main Bank Scottsbluff Phone: 308-632-7004 Toll Free: 888-632-7004
Wyoming Main Bank Torrington Phone: 307-532-2111 Toll Free: 800-777-8999

Regulatory Notices

Privacy Statement | Privacy Notices