Individual Pre-Approval Form

If you are applying for individual credit, but are relying on income from alimony, child support, separate maintenance, or on the income or assets of another person as the basis for repayment of the credit requested, complete an Individual With Stipulations Pre-Approval form instead. Mercantile Bank's authorized lending area includes all communities within a 100 mile radius of Quincy.

I. Personal Information

First Name

Last Name

E-mail Address

Address

City

State ZIP

Telephone

Date of Birth

/ /

Social Security

- -

Residence Type:

Own
Rent

Family
Other

Length of Time at Address:

Years Months

Mortgage Payment or Rent:

II. Employment Information

	Check if self-employed
Employer
Occupation
Position/Title
Address

City		State ZIP
Telephone
Gross Annual Income $

III. Nearest Relative or Friend Not Living With You

First Name
Last Name
Address

City	State ZIP
Telephone

When you submit this form, your request will be forwarded to a Mercantile Loan Representative, and you will be presented with a confirmation page showing the completed pre-approval form, formatted for printing to your local printer. After you have received one-hour loan pre-approval, bring your completed, printed application and approval to a Mercantile Auto Dealer Partner for processing. This pre-approval form allows you to complete paperwork from the convenience of your computer; it is not a guarantee of credit approval. Certain auto dealers may require additional information.

Everything that I/we have stated in this application is correct to the best of my/our knowledge. I/we understand that you will retain this application whether or not it is approved, you are authorized to check my/our credit and my/our employment history and to answer questions about your credit experience with me/us.

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