Sparta, Wisconsin Union National Bank & Trust Co.
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Loan Application

INSTRUCTIONS
You may apply for individual or joint credit, but check only one of the following boxes.
Individual Credit - Unmarried Applicant. Complete only the left hand columns on both sides of this form and other sections as they apply.
Individual Credit - Married Applicant. If both you and your spouse are residents of Wisconsin, complete both the left and right hand columns. If either you or your spouse are not Wisconsin residents, complete only the left hand column.
Joint Credit - With your Spouse. Complete the left and right hand columns on both sides of this form and other sections as they apply.
Joint Credit - With another applicant or
cosigner who is not your spouse.		 Each of you must complete a separate application. If both you and your spouse are Wisconsin residents include information about your spouse in the right hand column.
NOTICE TO MARRIED APPLICANT: No provision of a marital property agreement, a unilateral statement under Wis. Stat. sec. 766.59 or a court decree under Wis. Stat section 766.70 adversely affects the interest of the bank unless prior to the time the credit is extended, the bank is furnished with a copy of the agreement, statement or decree, or has actual knowledge of the adverse provision when the obligation to the bank is incurred.

LOAN
I/We Hereby apply for:
A direct loan of:    
no. of payments:    
amount of payments:    
  purpose of direct loan 
A Credit line of for purpose of
Collateral:Titled in the name of:Address:Insured by:
Collateral:Titled in the name of:Address:Insured by:
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©2012 Union National Bank & Trust Co. All rights reserved. | 124 W Oak St, PO Box 249, Sparta WI 54656 | Phone: (608) 269-6737
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