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If you would like us to contact you regarding a loan application, please provide as much information below as possible. An FLBA of North Alabama representative will be in contact with you within 24 hours (48 hours if submitted on Saturday) to discuss your needs. If you would prefer to have a loan application mailed to you, please
call us toll-free at 1-888-305-0074.
Name:
Address:
City:
State:
Zip Code:
Home Phone:
Work Phone:
E-mail Address:

Purpose of loan: (choose one or more)
Equipment Purchase
Agri-Business Financing
Rural Home Purchase/Construction
Land Purchase
Construction
Operating Capital
Refinance Another Loan
Other

County in which property is located:

Loan amount requested: $
Questions or comments:

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