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Home Improvement Application

Loan Information
   

Amount Requested*

 

Term of Loan*

    

Property*

 
                        
     

Occupancy*

 
                        
 

Location of Property*

 
Form of Identification
Why am I being asked this information? USA Patriot Act
  Applicant Co-Applicant

Are you a US Citizen?*

 
                        
 
                        

If No, Describe Immigration Status

 

Date of Birth*

Social Security No.*

Mother's Maiden Name

Type of Identification*

Other Identification Type 

Issued By*

Number*

Issue Date*

Expiration Date*

  

  

     
Federal Regulation requires us to obtain from you the type of credit for which you are applying. 
Please check one below:
       

Personal Information
   

Applicant Co-Applicant

First Name*

  

Middle Name

Last Name*

  

Current Address (No. and Street)*

  

City*

State*

Zip*

Years There*

  
Former Address Required if at Current Address for less than 2 years

 

Former Address (No. and Street)

  

City

     

State

Zip

Employment Information
 
 

Present Employer*

Position*

  

No. of Years There*

Gross Monthly Wages*

  

Business Phone*

  

Former Employer (if less than 3 Years)

Other Income Information
 
 

Additional Income

Source

  
Optional Income: Alimony, child support or separate maintenance received are optional information and need not be revealed if the applicant does not choose to rely on such income in applying for credit.

 

By submitting this application you certify that you are at least 18 years of age and the information you have provided is correct and complete as of the date of this application. You authorize us to verify your credit and employment history. You agree that, if your application is approved, you will be bound by the terms and conditions set forth in the underlying account agreement.

NOTICE: CNB may obtain a consumer credit report (credit history) from consumer reporting agency (credit bureau) on the applicant(s) at the time of the application and may also obtain additional consumer credit reports in the future for updates, renewals, extensions and collection activity for any approved account. Upon request, the lender will tell the applicant whether the lender obtained a report and if so, the name and address of the consumer reporting agency, which provided the report. You may instruct Canandaigua National Corporation not to share information (other than information related to account history and our experiences with you) within the Canandaigua National Corporation family of financial company services companies, by calling us toll free at 1-800-724-2621. You have the right to notify the lender if it reports any inaccurate information about your account to a credit bureau. Such notices should be sent in writing to the lender at 72 S, Main St., Canandaigua, New York 14424. You consent to and authorize CNB and it's affiliates to monitor and/or record your telephone conversations with any of its representatives to ensure quality service. By submitting this application, applicant(s) agree that they have applied for the account as indicated above. They agree to pay the full amount of any credit extended by the lender, including finance charges and other fees that may be due under the terms of the account agreements if an account is opened.