"Loan Application Form - Nh Hicks"

ADVERTISEMENT
LOAN APPLICATION
PLAN NAME:
I hereby request a loan in the amount of $
from my account in the above named
plan with the following terms:
Participant _________________________________________________
Length of Loan ______________________________________________
(Not to exceed 5 years unless used for the purchase of your principal residence.)
Interest Rate
Current prime interest rate from a commercial bank plus __ % or
Other
% will require bank documentation to be attached
Payment terms (check one)
Weekly (52 payments per year)
Bi-weekly (26 payments per year)
Semi-monthly (24 payments per year)
Monthly (12 payments per year)
Quarterly (4 payments per year)
Security for Loan
Vested Account Balance
Other
MARITAL STATUS. I am (check one)
married
not married
(If you are married, your spouse must sign the promissory note that will follow)
I understand that any outstanding loan balance will be due and payable upon my termination of
employment and will be deemed a taxable event upon receipt of my benefit due from the plan.
Date
Participant's Signature
Social Security #
Note:
A loan initiation fee and annual maintenance fees may apply.
LOAN STATEMENT - The loan is:
Approved for $
Not Approved
Loan fees to be paid by participant:
Yes
No
Payment Procedure: Payroll Deductions:
Yes
No, then how
First Payment Date:
Date
Plan Trustee’s Signature
HICKS
NH
LOAN APPLICATION
PLAN NAME:
I hereby request a loan in the amount of $
from my account in the above named
plan with the following terms:
Participant _________________________________________________
Length of Loan ______________________________________________
(Not to exceed 5 years unless used for the purchase of your principal residence.)
Interest Rate
Current prime interest rate from a commercial bank plus __ % or
Other
% will require bank documentation to be attached
Payment terms (check one)
Weekly (52 payments per year)
Bi-weekly (26 payments per year)
Semi-monthly (24 payments per year)
Monthly (12 payments per year)
Quarterly (4 payments per year)
Security for Loan
Vested Account Balance
Other
MARITAL STATUS. I am (check one)
married
not married
(If you are married, your spouse must sign the promissory note that will follow)
I understand that any outstanding loan balance will be due and payable upon my termination of
employment and will be deemed a taxable event upon receipt of my benefit due from the plan.
Date
Participant's Signature
Social Security #
Note:
A loan initiation fee and annual maintenance fees may apply.
LOAN STATEMENT - The loan is:
Approved for $
Not Approved
Loan fees to be paid by participant:
Yes
No
Payment Procedure: Payroll Deductions:
Yes
No, then how
First Payment Date:
Date
Plan Trustee’s Signature
HICKS
NH
AUTHORIZATION FOR PAYROLL DEDUCTIONS
To be completed and provided to payroll department upon completion of amortization schedule
PLAN NAME:
Participant:
Social Security #:
I hereby authorize payroll deductions in the amount of $
with a final payment of
$
for a period of
years.
Date
Participant’s Signature
Date
Witness’s Signature
Note: All payroll deductions for loan repayment must be made on an after-tax basis.
HICKS
NH
ADVERTISEMENT

Download "Loan Application Form - Nh Hicks"

484 times
Rate
(4.7 / 5) 34 votes
Page of 2