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.
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.
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.
If Section B has been completed, this section should be completed giving information about both the Applicant and Joint Applicant or Other Person. If Section B was not completed, only give information about the applicant in this section.
Complete this section only if credit is to be secured. Briefly describe the property to be given as security.
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By clicking Submit below, I certify that everything I have stated in this application is correct. Citizens National Bank may keep this application whether or not it is approved. By submitting this application I authorize Citizens National Bank to check my credit and employment history and to answer questions others may ask Citizens National Bank about my credit record with Citizens National Bank. I understand that I must update credit information at the request of Citizens National Bank if my financial condition changes.
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Citizens National Bank — Member FDIC, Equal Housing Lender