To Pre-Apply, having already read and accepted account disclosures, simply complete and submit application. A representative of the Miners National Bank of Eveleth will contact you upon approval to make arrangements for you to come in to sign the necessary documents to activate your account.

Feel free to contact us with any questions you may have.

* = Required Field

All applicants must complete Section A. If you are applying for a consumer deposit account, complete Sections A and B. If you are applying for a consumer loan, complete Sections A and C. If you are applying for both deposit and loan accounts, complete all three sections.

If you work in Minnesota and reside outside of Minnesota please contact us.

I am applying for:
(check all that apply)

DEPOSIT ACCOUNTS
Personal Regular Checking
Personal Basic Checking
Personal Student Checking
Personal Miners Checking
Miners Gold Checking
N.O.W. Checking
Passbook Savings
Christmas Club Savings
Certificates of Deposit


LOANS
Real Estate Loans
Personal and Installment Loans
Auto and Recreational Loans
Student Loans
Overdraft Protection Loans
Home Equity Loans

SECTION A - General Information
Last Name:*
First Name:*
Middle Initial:*
Home Address :*
City:*
State:
MN
Zip Code:*
Mailing Address (if applicable):
City:
State:
MN
Zip Code:
Previous Home Address:
City:

State:

Zip Code:
Home Phone (please include area code):*
Email Address:

Fax:
Date of Birth:*

Social Security Number:*
Employer:*

Employer Address:
City:
State:

Zip Code:
Employer Telephone:
Years There:

Position / Title:

Previous Employer (if less than 2 years at current employment):

Previous Employer Address:

City:
State:

Zip Code:
Joint Applicant Information
*Note, you do not need to fill out this section unless you are applying for a joint application
Last Name:
First Name:
Middle Initial:
Home Address :
City:
State:
Zip Code:
Previous Home Address:
City:

State:

Zip Code:
Home Phone (please include area code):
Email Address:

Fax:
Date of Birth:

Social Security Number:
Employer:

Employer Address:
City:
State:

Zip Code:
Employer Telephone:
Years There:

Position / Title:

Previous Employer (if less than 2 years at current employment):

Previous Employer Address:

City:
State:

Zip Code:
SECTION B - Deposit Account Information
CD Term:
(This is only if you choose a Certificate of Deposit)

CD Interest:
(This is only if you choose a Certificate of Deposit)

Amount of Initial Deposit:
Please Provide The Following Verification Information:
Name of Current Bank:
Address of Bank:
City:
State:
Zip Code:
Account Number:
MN Drivers License or State Iissue ID Number:*
Are you a US Citizen?
Yes
No
NOTE: If you do not have a drivers license or state issued ID, please call one of our Customer Service Representatives at (218) 744-5465.
Nearest Relative Not Living With You:

Address:
City:
State:

Zip Code:
Phone Number (including area code):
Mother's Maiden Name (for security purposes):
The Following Services Are Subject To Credit Approval:
Would you like to apply for an Miners Bank of Eveleth VISA Check Card?:
Yes     No
If so, please pick four numbers for your secret code:
Please reconfirm your secret code:
* Would you like to apply for overdraft protection?:
Yes     No
If yes, please complete Income Information in Section C of this application
SECTION C - Loan Application Information
Purpose of Loan:
Amount Requested:

Gross Annual Income:

Length of Repayment Requested:

(NOTE: Alimony, child support or separate maintenance income need not be revealed if you do not wish to have it considered as a basis for repaying this obligation)
Do you own your home (or other real estate you would offer as collateral):
Yes   No
If yes, please provide the value of that real estate:
Amount of First Mortgage:
Amount of Second Mortgage:
 
By clicking on the Submit button below, I (We) pre-apply for the loan and/or deposit products listed above and certify that all information provided above is correct and authorize you to check my (our) credit and verify the information provided in this application. I (We) also certify under penalty of perjury that the Social Security Number(s) provided above is/are correct and that I am not (we are not) subject to backup withholding under the Internal Revenue Code. I (We) understand that additional information may be required before a decision can be made regarding this application. I (We) further understand that approval by the Miners National Bank of Eveleth for any of the loan or deposit product is conditioned on my (our) agreement to abide by all terms and conditions contained in the applicable loan agreement and/or deposit agreement and that no account will be activated until I (we) have signed all necessary documents required by the Miners National Bank of Eveleth. I further agree to return any access device for obtaining funds from any type of account upon demand by the Miners National Bank of Eveleth. I have read the above statement and agree to the terms set out therein.
 
I HAVE READ THE ABOVE STATEMENT AND AGREE TO THE TERMS SET OUT THEREIN.
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