Personal Loan Application

Applicant Information

Answer the following questions about yourself. Indicate your marital status only if you live in Texas or in another community property state.

Are you applying for joint credit?

Yes
No

Applicant Initials Your Full Name Street Address City State Zip Code Years There Home Phone Number Cell Phone Number Email Birth Date Social Security Number Driver's License Number State Issued

Are you a permanent U.S. resident?

Yes
No

Are you

Married
Unmarried
Separated

Age of Dependents

Do you

Own
Rent
Live with Parents

Monthly Payment If Own, Financed by Last Address City State Zip Code Years There Your Employer Address City State Zip Code Years There Position Business Phone Number Extension Monthly Take Home Pay Monthly Commission/Bonus Other Monthly Income Income Source

You are not required to give us infomation on alimony, child support or maintenance payments you receive unless you want us to consider it in evaluation your application.

Monthly Amount Last Employer Address City State Zip Code Years There Position Bank Savings Account Number Bank Checking Account Number Other Bank/Account Number

Co-Applicant Information

Answer the following questions about any co-applicant who will be equally responsible for repaying the loan. If you have more than one co-applicant, complete a separate application for each co-applicant.

Are you applying for joint credit?

Yes
No

Co-Applicant Initials

Your Full Name Street Address City State Zip Code Years There Home Phone Number Cell Phone Number Email Birth Date Social Security Number Driver's License Number State Issued

Are you a permanent U.S. resident?

Yes
No

Are you

Married
Unmarried
Separated

Age of Dependents

Do you

Own
Rent
Live with Parents

Monthly Payment If Own, Financed by Last Address City State Zip Code Years There Your Employer Address City State Zip Code Years There Position Business Phone Number Extension Monthly Take Home Pay Monthly Commission/Bonus Other Monthly Income Income Source

You are not required to give us infomation on alimony, child support or maintenance payments you receive unless you want us to consider it in evaluation your application.

Monthly Amount Last Employer Address City State Zip Code Years There Position Bank Savings Account Number Bank Checking Account Number Other Bank/Account Number

Assets (What you have of value)

Cash on Hand and in Bank Accounts

Debts Others Owe You

Cash Surrender Value of Life Insurance (Not face value)

Stocks and Bonds and Other Securities (Retirement Plan)

Value of Real Estate & city located in

 Add Another Real Estate

Value & Year of Autos

 Add Another Automobile

Other Assets

 Add Another Asset or Account

Liabilities (What you owe)

Bank Loans - Secured

Bank Loans - Unsecured

Taxes Due

Liens - Claims Against Real Estate

Other Liabilities (Revolving, Credit Cards)
List by each card and amount owed

 Add Another Liability

Total Assets:

Total Liabilities:

Net Worth (Assets - Liabilities):

Total Liabilities + Net Worth (Should equal Total Assets):

Applicant Statement

I have answered all of the questions on this application fully and truthfully. I authorize you to investigate my and my co-applicant's credit record to check statements I've made. This application is your property and I understand you will keep it whether or not I receive the credit I've asked for.

We may report information about your account to credit bureaus. Late payments, missed payments, or other defaults on your account may be reflected in your credit report.

Applicant's Signature Date

Co-Applicant Statement

I have answered all of the questions on this application fully and truthfully. I authorize you to investigate my and my co-applicant's credit record to check statements I've made. This application is your property and I understand you will keep it whether or not I receive the credit I've asked for.

We may report information about your account to credit bureaus. Late payments, missed payments, or other defaults on your account may be reflected in your credit report.

Co-Applicant's Signature Date

Loan Information

Applicant Information

Are you applying for joint credit?

Are you a permanent U.S. resident?

Are you

Do you

Co-Applicant Information

Are you applying for joint credit?

Are you a permanent U.S. resident?

Are you

Do you

References (other than someone who lives with you)

Reference

Credit Information

Are there any unsatisfied judgments against you?

Have you ever had a car or other merchandise repossessed?

Have you been through bankruptcy or made settlement with creditors?

Assets (What you have of value)

Liabilities (What you owe)

Cash Flow

Monthly Expenses

Monthly Credit Obligations

Federal Credit Application Insurance Disclosure

Applicant Statement

Co-Applicant Statement