Contact A Lender

Please complete the form below and a xxxx xxxx xxxxxx banker will get in touch with you.

This form is for business and home lending purposes only. Information submitted to Premium Guaranty Bank will be kept confidential and transmissions will be secure according to industry standards. Check out our Privacy Policy. A final loan decision cannot be made until a complete application and supporting documentation are received and verified. This is not a commitment to lend or to open an account. We cannot accept prequalification applications from persons under age 18. Many of the fields are optional. You must complete the required information in order for this form to be transmitted to xxxx xxx xxxx xxxx.

Personal Information

* required

Full Name *

Date of Birth *

Marital Status *

Phone

Preferred Method of Contact *

Loan Type *

Personal Information

* required

Full Name *

Date of Birth *

Marital Status *

Phone

Preferred Method of Contact *

Loan Type *

Current Residence

Current Address (street, city, state, ZIP)

Rent or Own?

Number of Years (Years/Months)

Current Residence

Current Address (street, city, state, ZIP)

Rent or Own?

Number of Years (Years/Months)

Employment Information

Name of Employer

Self Employed

Position/Title

Years on this job

Years employed in this line of work/profession

Business Phone

Gross Monthly Income

Employment Information

Name of Employer

Self Employed

Position/Title

Years on this job

Years employed in this line of work/profession

Business Phone

Gross Monthly Income

Transaction Information

Estimated Loan Amount

Preferred Banker

How did you hear about Premium Guaranaty?

Additional Comments

Confidential information, such as account numbers or social security numbers, should not be transmitted via email. Instead, please contact Valor Bank directly at your nearest bank location.