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General Information

  • Are there any returns being contested or audited? *

Loan Request

Loan Request

  • Status of Financial Statement *
  • Assets

  • Liabilities

Profit and Loss

Equal Credit Opportunity Notice

  • Were your gross revenues $1,000,000 or less in your previous fiscal year? *

If you answered "yes" and the creditor denies your application for credit, you have the right to a written statement of the specific reasons for denial. To obtain the statement please contact:
COMMERCIAL LOAN DEPT.
FOWLER STATE BANK
300 E 5TH STREET
FOWLER, INDIANA 47944
(765)-884-1200
within 60 days from the date you are notified of the Creditor's decision. The Creditor will send you a written statement of reasons for the denial within 30 days of recieving your request for the statement.

The Federal Equal Credit Opportunity Act prohibits creditors from discriminating against credit applicants on the basis of race, color, religion, national origin, sex, marital status, age (providing the applicant has the capacity to enter into a binding contract), because all or part of the applicant's income derives from any public income assistance program, or because the applicant has in good faith exercised any right under the Consumer Credit Protection Act, the federal agency that administers compliance with this law concerning this creditor is:
FDIC CONSUMER RESPONSE CENTER
2345 GRAND BOULEVARD, SUITE 100
KANSAS CITY, MISSOURI 64108

The signer(s) certify that all information provided above is a complete and true statement of the financial condition of the undersigned individuals on the date indicated. The signer(s) authorizes Fowler State Bank ("Bank") to obtain consumer and/or business reports in their names as individuals at any time and to verify all portions of this financial statement, including all financial statements and federal tax returns, with appropriate sources. The Bank is also authorized to provide credit information about the signer(s) to other creditors and credit reporting agencies. The signer(s) also agrees to provide any further information the Bank may require to process this application.