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To begin the application process for a CHELSEA BANK loan please complete the information below, print the form and mail to:

Ms. Janice Sikorski
CHELSEA BANK
P. O. Box 505687
360 Broadway
Chelsea, MA 02150-5687

______________________________________________
Full Name of Applicant

______________________________________________
Full Name of Co-Applicant

______________________________________________
Street Address

______________________________________________
City, State & Zip

______________________________________________
Phone Number

______________________________________________
Cell Phone Number (if applicable)


Applicant

Annual Income_______________

Employer_____________________ Phone Number_____________

______________________________________________
Employer Address

Length of Employment______________

Applicant Signature______________________________________

Co-Applicant

Annual Income_______________

Employer_____________________ Phone Number_____________

______________________________________________
Employer Address

Length of Employment_______________

Co-Applicant Signature___________________________________

Type of Loan

Home Mortgage

Fixed Rate_____ Adjustable Rate_______ First Time Homebuyer_____
MassAdvantage_____ MassAdvantage100_____

Non-Owner Occupied Mortgage_____

Home Equity Line of Credit_____

Fixed Home Equity Loan/2nd Mortgage_______

Personal Loan
Auto Loan_____ Passbook Loan_____ Personal Loan______

Fixed Home Improvement Loan ______

Overdraft Line of Credit _______

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CHELSEA BANK
360 Broadway, PO Box 505687, Chelsea, MA 02150-5687
Phone: 617-884-5600 Fax: 617-884-2590
eMail: info@cpcbank.com

All deposits
are fully
insured:
Member SIF, FDIC, Equal Housing Lender