HELOC Inquiry

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Please complete the following information as a first step to applying for your HELOC Loan. A Fairfax State Savings Bank lender will be in touch with you to discuss the next steps for this process.

Required Field *


You are being asked to guarantee this debt. Think carefully before you do. If the borrower doesn't pay the debt, you will have to. Be sure you can afford to pay if you have to, and that you want to accept this responsibility. You may have to pay up to the full amount of the debt if the borrower does not pay. You may also have to pay late fees or collection costs, which increase this amount. The Lender can collect this debt from you without first trying to collect from borrower. The Lender can use the same collection methods against you that can be used against the borrower, such as suing you, garnishing your wages, etc. If this debt is ever in default, that fact may become a part of YOUR credit record. This notice is not the contract that makes you liable for the debt.

  • Borrower

  • Current Address

  • Previous Residence

    Previous Residence

  • Employment Information

    • Alimony, child support, or separate maintenance income need not be revealed if you do not wish to have it considered as a basis for repaying this obligation.

I/We would like to begin the application process for the loan or credit described above. I/We certify that the information provided is true and complete. Lender is authorized to verify the information provided with other parties and to make investigation of my/our credit, either directly or through any agency employed by Lender for that purpose. I/We understand that additional information may be needed to complete the application for the underwriting process. I/We understand that Lender will retain this information and any other credit information Lender receives, even if no loan or credit is granted.