Physician Loan Application

SunTrust does not endorse or have any associations with any loan brokers who charge clients a fee for accessing our application.
Type of Application
Are you applying individually or jointly?
I am applying for an individual account in my own name and relying on my own income or assets - not the income or assets of another person - as the basis for repayment of the credit requested.
We are applying for joint credit and are relying on our joint income and assets as the basis for repayment of the credit requested.
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(Only available to doctors in practice in the states of AL, AR, FL, GA, MD, MS, NC, SC, TN, VA, Washington, D.C., and WV.)
Contact Information
First Name *MILast Name *
Street Address*
Apt./Unit #
City *State/Province*
Zip/Postal Code*
Country
Preferred Method of Contact
Primary Phone*Cell PhoneWork Phone*
(Example: XXXXXXXXXX)(Example:XXXXXXXXXX)(Example: XXXXXXXXXX)
You agree as follows: On each phone number that you give us on this application, whether land line or cell phone, you consent to SunTrust Bank, its affiliates, our agents, and assignees of any of us contacting you at the number by calling, texting, or sending other electronic messages, from time to time, for any reason about your accounts with SunTrust Bank and its affiliates, including but not limited to, for collection and payment purposes. You agree that automated dialing equipment or prerecorded voice messages may be used for any of these purposes.
Email Address*
* Indicates a required field.
Additional Information
Social Security Number(do not use dashes, only input numbers) *Date of Birth (mm/dd/yyyy) *
Yes, I'd like a loan for $*Existing SunTrust physician loan customer*
Loan Purpose *
My Status *(note: If Permanent Visa, please fax a copy to 866-670-6933.)
PGY (if applicable)
Medical License Number
Medical License State
Specialty
Employer*
Annual Salary $*
Other Income $Source of Income
* 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. You may include income from any source.
Medical School *Year Graduated
Residency *Completion Date
FellowshipCompletion Date
Co-Applicant
First NameMILast Name
Social Security NumberDate of Birth
EmployerBusiness Phone Number
Annual Salary $(Example: XXXXXXXXXX)
Other Income $Source of Income
* 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. You may include income from any source.
Total Assets Are Comprised of
Stocks/Bonds $Cash $
Pensions $
Liabilities Are Comprised of
Home Ownership *
Monthly Rent/Mortgage payment $*
Total balance of all your Bank Charge Cards $ *
Total balance of all your Education Loans $ *
Total monthly payment for all of your Educational Loans $
Total Monthly payments for auto loans $
Are you paying alimony or child support? *
If you are paying alimony or child support what is the total
monthly payment $
Have you ever declared Bankruptcy?*
Nearest Relative not living with you *
Nearest Relative's Address *
Nearest Relative's City *
Nearest Relative's State *
Nearest Relative's Zip *
Nearest Relative's Phone *
(Example: XXXXXXXXXX)
How did you learn about our program?
Reservation Code
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Additional Comments (Please enter less than 8 lines of information)
By submitting this application through the Internet, the Applicant(s) certifies that all information contained in this application or in any other document submitted for the purpose of obtaining credit is true, complete, and correct and accurately reflects Applicant(s)' current financial condition. In order to provide the Applicant with SunTrust products and services, Applicant(s) authorizes SunTrust Bank, its affiliates, or its authorized agents to verify any and all information to make any inquiries of others, including but not limited to, procuring reports from consumer reporting agencies, credit bureaus, and the Internal Revenue Service, and to provide information arising from Applicant(s)' transaction or experience with if to others. Any reference, employer or creditor named herein is expressly authorized to furnish Bank with information in connection with this application. This application shall remain the property of SunTrust. Bank may require Applicant to provide updated financial information on an annual basis.

Wisconsin Residents: No provision of a marital property agreement, a unilateral statement under the marital property law, or a court decree adversely affects the interest of the creditor unless the creditor, prior to the time the credit is granted, is furnished with a copy of the agreement, statement or decree or has actual knowledge of the adverse provision when the debt to the creditor is incurred.

Federal law requires all financial institutions to notify applicants that they will obtain, verify and record information that identifies each person who opens an account. When you open an account we are required to ask your name, address, date of birth, and other information that will allow you to be identified as the account applicant. In addition, we may also ask to see your driver's license or other identifying documents in order to verify this information.
*I have read and acknowledged the above disclosures and certification regarding the accuracy of the information I am submitting.