Flood Relief Loan

Information Gathering Form

Please fill out the information below to be considered for a 5 year Flood Relief loan with Frontier Bank. Once we receive the completed form, a Frontier Bank lender will be in touch within 1-2 business days.

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* Preferred Frontier Bank Branch:

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* How did you hear about the Flood Relief Loan Program?

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* Amount Requested (Maximum of $20,000):

Borrower Information

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* Applicant:

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* Are you a US Citizen?

Yes

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* Email Address:

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* Phone Number:

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* Do You (Please select one):

Rent

Own

Live with family

Other (please specify)

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* Present Address:

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* If residing at your present address for less than 2 years, complete the following

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* Employer:

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* Job Title:

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* How long have you worked for this employer?

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* Monthly Gross Income:

Co-Applicant Information (If applicable)

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* Co-Applicant:

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* Email Address:

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* Phone Number:

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* Employer:

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* Job Title:

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* How long have you worked for this employer?

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* Monthly Gross Income:

Underwriting Standards Apply.