1st National Bank: Aircraft Loan Application

ATTENTION: You have two choices for filling out this form: (1) You can simply fill in all of the blanks if you have a forms compatible web browser and click the submit button at the bottom of this form or (2) You can print this form out on your printer, fill in all the necessary information and then fax it to us at 1st National Bank of Pryor at 918-825-0519.

Please note: Although it is most unlikely that you will experience any problems responding to this form, certain non-standard browsers will not respond properly. If you experience any difficulties, (or if you are not using a forms-capable browser) you may email your response to this form to: Mike Jacobs.

Remember, in order to process your application, you must fax (for fastest response) or mail us copies of your last two years tax returns, pilots license and drivers license.

**Contact Information**
Fax:	(918) 825-0519
Voice:	(800) 462-7032
Email:	jacobs at 1st-of-pryor.com "replace at with @"
Attention:	Mike Jacobs
Address:	1st National Bank of Pryor
	P.O. Box 218
	Pryor, OK 74362

*Annual (mm/dd/yy):
*100 Hr Inspection (mm/dd/yy):
*Will the aircraft be hangared?	Yes No
*Where is aircraft based:
*List Avionics/Equipment Below:

Employment History:

Present Employer

*Employer:
*Position:
*Phone:
*Street Address:
*City:
*State:	*Zip Code:
*Salary $:	*per:
*Years There:

Previous Employer

*Previous Employer:
*Position:
*Phone:
*Street Address:
*City:
*State:	*Zip Code:
*Salary $:	*per:
*Years There:

Nearest Relative

*Nearest Relative's Name:
*Phone:
*Street Address:
*City:
*State:
*Zip Code:

Other Income:

Applicant $:	per:
Source:

Bank References
Bank Accounts	Bank Name		Phone
Bank Accounts	Account #	Balance	Contact
Checking 1
Checking 1

Checking 2
Checking 2

Savings 1
Savings 1

Savings 2
Savings 2

Money Market / CD
Money Market / CD

IRA / KEOGH
IRA / KEOGH

Mortgage 1
Mortgage 1

Mortgage 2
Mortgage 2

Vessel / Aircraft / RV
Vessel / Aircraft / RV

Vehicles Loan(s)
Vehicles Loan(s)

Other Loans
Other Loans

Credit Cards
Credit Cards

What You Own
Checking:
Savings:
IRA / KEOGH:
Real Estate:
Securities, Marketable:
Securities:
Vessel / Aircraft:
Recreational Vehicles:
Vehicles:
Personal Property:
Other Assets 1:
Other Assets 2:
Other Assets 3:

Total Owned:

What you owe
Debt Type	Unpaid Balance	Monthly Payment	Months Remaining
Accounts Payable / Credit Cards:
Notes Payable Vessel / Aircraft / RV:
Mortgage Balance -- Income Property:
Mortgage Balance -- Residence(s):
Home Equity Loan (2nd Mort.):
Margin Loan (securities):
Loans w/ Life Ins. Co.:
Other Liabilities 1:
Other Liabilities 2:
Other Liabilities 3:
Other Liabilities 4:

Total Debts:
Net Worth (Tot. Owned - Tot. Debts):
Tot. Debts & Net Worth (Tot. Debts + Net Worth):

Contingent Liabilities:

Do you have any contingent liabilities? If yes, give details:

As endorser, co-maker or guarantor:
On leases and contracts:
Legal claims:
Other specific debt:
Amount of tax liens:

General Information:

Are any assets pledged?

Yes No

Are you a defendant in any suits or legal action?

Yes No

Personal bank accounts carried at:

Have you ever filed bankruptcy? If so, explain:

I acknowledge that I have made this application with the intent that you should rely upon the information contained herein in granting the credit requested. I understand that, if the requested information is granted, you may report information concerning the credit to consumer reporting agencies and to others. I affirm that my answers are complete and true and authorize you to verify or obtain any information concerning them. Upon your request, I further authorize any firm or individual from whom I may have obtained or requested credit, to furnish you with the details of that transaction. I also agree to provide current financial information upon request, in a form that is acceptable to you.

Yes No

*Social Security Number:
*Date of Birth (mm/dd/yy):
*Place of Birth:
*Are you a U.S. citizen?:	Yes No

*What do you plan to do with your present aircraft?	Trade Refinance Sell Continue to use Don't Currently Own
*Will the aircraft be leased?	Yes No
*Aircraft titled in name of:
*Is the aircraft new or used?	New Used
*Aircraft Make:
*Aircraft Model:
*Aircraft Year:
*Registration Number:
*Serial Number:

*Airframe:	hours
*Engine(s):	hours

*Major Overhaul:	hours
*Hot Section:	hours

Current Residence:

Previous Residence:

General:

Aircraft Information:

Maintenance:

TIME:

TIME: Since...

DATE: Of last...

Employment History:

Present Employer

Previous Employer

Nearest Relative

Other Income:

Bank References

What You Own

What you owe

Contingent Liabilities:

General Information:

*Years at this address:
*County:
*Street Address:
*City:
*State:
*Zip Code:
*Home Phone:
*Office Phone:

Are any assets pledged?	Yes No
Are you a defendant in any suits or legal action?	Yes No
Personal bank accounts carried at:

*Name:
*Your Email Address: