Consumer Loan Application

LOAN REQUEST  
*Purpose of Loan
*Amount Requested
*Months Needed
PERSONAL INFORMATION  
This application is designed to be completed by the applicant(s) with the lender's assistance.
The Co-Applicant section and all other Co-Applicant questions should be completed to the extent possible if: (1) co-applicant will be jointly obligated with you on the loan; (2) you will be relying on income or assets of the co-applicant as a basis for repayment of the loan; (3) you are relying on income from alimony, child support, or separate maintenance from the co-applicant or other party; or (4) you are married to the co-applicant and reside in, or the property is located in, a community property State. If you are married, your spouse need not be jointly obligated with you on the loan and need not sign as a co-applicant unless item (2) above applies or unless the spouse's signature is required under state law to create a valid lien, pass clear title or waive inchoate rights to property.
APPLICANT
*Full Name
*Date of Birth
*Present Address
*City, State Zip ,
*Rent or Own
*Years at address
*Phone Number
*Email Address
Previous Address (complete if less than 2 years at present address)
*City, State Zip ,
*Social Security Number
Employer Name
How Long?
Position/Title
Previous Employer
Complete if current job held less than 2 years
How long
Position/Title
Are there any unsatisfied judgments against you?
In the last 7 years, have you been declared bankrupt?
Did you ever have credit in any other name?
If yes, what name?
 
CO-APPLICANT
Full Name
Date of Birth
Present Address
City, State Zip ,
Rent or Own
Years at address
Phone Number
Previous Address (complete if less than 2 years at present address)
City, State Zip ,
Social Security Number
Employer Name
How Long?
Position/Title
Previous Employer
Complete if current job held less than 2 years
How long
Position/Title
Are there any unsatisfied judgments against you?
In the last 7 years, have you been declared bankrupt?
Did you ever have credit in any other name?
If yes, what name?


Assets
DEPOSITS IN CHECKING & SAVINGS ACCOUNTS Amount/Value
Name of Institution Type Account No. Applicant Co-Applicant
$ $
$ $
$ $
Vehicles
List/Make Year Fully Paid. Applicant Co-Applicant
Yes  No $ $
Yes  No $ $
Yes  No $ $
Real Estate Owned
Description Applicant Co-Applicant
$ $
$ $
TOTAL ASSETS
TOTAL ASSETS $ $
 
INCOME
Monthly Income Applicant Co-Applicant
Gross Base Earnings $ $
Overtime $ $
Bonuses-Comissions $ $
Other-Optional-See Remarks $ $
Income Remarks Note: Income from Alimony, Child Support or Maintenance Payments need not be disclosed if you do not wish to have it considered as a basis for Repaying this obligation.
TOTAL INCOME
TOTAL INCOME $ $


LIABILITIES OBLIGATIONS CREDIT REFERENCES
NOTE: List all personal, trust partnership, or corporate debts. If recently paid off, list for credit reference, include debts for 1st and 2nd lien loans (Mortgage or Trust Deed), autos, appliances, furniture, personal loans and notes, co-signed notes, alimony, support payments, and charge accounts.
Purpose Applicant/
Co-Applicant/
Joint
Owed To (Name & Address) Monthly Payment Balance Owed
$ $
$ $
$ $
$ $
$ $
$ $


PERSONAL REFERENCE
Reference 1
Name of Nearest Relative
Not Living With You
-OR-
Personal Reference
Relationship
City, State ,
Phone Number


AGREEMENT
By clicking submit, I declare and represent that I have read the foregoing Application, that all statements made therein are complete and true to their knowledge, that all financial and credit information of value to the consideration of this Loan Request has been given that the statements are made and information given as an inducement to the Lender to grant the Loan for which this Application is made. The Applicant(s) authorize the Lender, or his Agent, to verify the information contained herein and to make such additional normal inquiries information, along with this Application, shall remain the Lender's property. I undersigned understand that the selection of a dealer or contractor is their responsibility and that this financial institution in no way guarantees equipment, materials or workmanship and that it is a federal crime punishable by fine or imprisonment or both to knowingly make any false statements concerning any of the above facts, as applicable under the provisions of Title 18, United States Code, Section 1014.