Loan Account Application
Thank you for your
interest in Jonestown Bank & Trust Co.
Part of our mission, as a community bank, is to provide the best
possible service to our customers. To meet this goal we limit on-line
applications to existing customers and other residents of our geographic
Our primary service area
is Lebanon County, Pennsylvania. Our secondary service area
is Western Berks, Southern Schuylkill, Eastern Dauphin, and Northern Lancaster Counties, Pennsylvania.
If you are not a current JBT customer or a resident of these areas, we may
deny your loan application solely based on that fact.
We invite you to submit
this application by completing the form below and clicking on the
"Submit" button at the end of the form. If your loan application is
approved, we will require that you visit one of our offices to sign the
necessary loan documents. Please select the branch office that would be most
convenient for you.
If you have any questions
about our products or need further assistance, please email us at firstname.lastname@example.org.
Warning: email is not secure; do not send sensitive information by way
of this link.
INFORMATION ABOUT PROCEDURES FOR OPENING A NEW ACCOUNT. 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, AND DATE OF BIRTH,
SOCIAL SECURITY NUMBER, AND OTHER INFORMATION THAT WILL ALLOW US TO IDENTIFY
YOU. WE MAY ALSO ASK TO SEE YOUR DRIVER'S LICENSE OR OTHER IDENTIFYING
a loan type:
NOT complete if this is an application for individual unsecured credit.
New Vehicle Loan
Used Vehicle Loan
Secured Personal Loan
Unsecured Personal Loan
Unmarried - includes single, divorced, widowed
– Personal Information
of Birth (MM/DD/YYYY)
(Must be at least 18
years of age.)
License Number (or Registered ID)
Employer Phone Number
– Address Information
(We cannot accept PO Box #s)
Address (if different from above)
(We cannot accept PO Box #s)
– Co Applicant Information
Complete the following information
if you have a Co-Applicant. If no Co-Applicant, skip to Step 4.
to Applicant, if any
Step 4 Income Information
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
– Loan Information
Collateral, i.e., certificate of deposit
Reference (Name and address of nearest relative not living with you)
there any judgments outstanding against you?
you been declared bankrupt in the past seven years?
a cosigner or co maker, endorser, or guarantor on any loan?
Comments - Provide additional information or
explanations relevant to your request for a loan.
6 - Acknowledgement
submitting this loan application, I certify that everything I have
stated in this application is correct. You may keep this application whether
or not it is approved. I authorize you to check my credit and
employment history, to obtain a consumer credit report in connection
with this application, and to answer questions others may ask about my
credit record with you. I understand that I must update credit
information at your request if my financial condition changes. I
further warrant that I am at least 18 years of age and a U.S.
document is being secured using SSL encryption provided by your browser.
Your information will be encrypted when using this form while in transit
between your browser and JBT.
If you desire, this form
may be printed and mailed to us at the address below.
Please print this form using the
"PRINT" button below, sign it, and mail it to us at:
Co-applicant Signature (if
Jonestown Bank & Trust Co.
ATTN: Internet Banking Services
421 E. Penn Avenue
Cleona, PA 17042