Please fill out the information below. A Farm Bureau Bank rural loan representative will contact you with more information about the rural loan program that will best fit your needs based on the information you provide.

* Indicates required fields
Personal Information

First Name MI Last Name
Address
City State Zip Code
Email Address
*Telephone
( ) -

Loan Type

*Is this a purchase or refinance?  
Purchase    Refinance

If it is a refinance, is it a cash-out refinance?  
 Yes    No

If it is a refinance, what is your current rate and term?  
Rate  %    Term  years   

Property Type

Is the property owner occupied, Second Home, or an investment property?  
Owner Occupied    Second Home    Investment Property

Estimated current value of property  
 .00

Estimated loan amount based on sales price or refinance amount  

What is the size of the acreage?  

Is the acreage used for farming or agricultural purposes?  
 Yes    No

Is this for the purchase or refinance of land only?  
 Yes    No

Credit History
* Have you had a collection problem on any loan or
    declared bankruptcy in the past three years?  
 Yes    No

Contact Information
* When is the best time for our mortgage loan officer
    to reach you should we need to call you back?  

Comments

Are there any farm type outbuildings such as barns, grain bins etc on the property?
If so, describe briefly in comments section.