Personal Loan Application

Loan Information

If the Applicant is married, they may apply for individual credit.

Are you applying as an individual or with a co-applicant? Individual Co-Applicant

Is this a secured or unsecured loan? Secured Unsecured

Purpose of Credit Requested Amount Requested Description of Collateral Offered

Applicant

First Name Middle Initial Last Name Suffix Social Security Number Birth Date Home Address City State Zip Code

Have you lived at this address for 2 or more years? Yes No

Previous Home Address City State Zip Code

Mailing address is different than street address. Mailing Address City State Zip Code Primary Phone Number Work Phone Number E-mail Address Please do NOT email me important news and updates.

How would you prefer to be contacted? Home Phone Work Phone Email Other

Other Preference

Citizenship

Citizenship U.S. Citizen Permanent Resident Alien Non-Resident Alien

Marital Status

Check one if you are (a) you are applying for a secured credit; (b) you reside in a community property state; or (c) you are relying on property in a community property state as a basis for repayment of the credit requested.

Housing Status Married Separated Unmarried (include single, divorced, widowed)

Dependents

Number of Dependents Age of Dependents (Separated by Comas)

Housing Status

Housing Status Own Rent Other

Explain Estimated Property Value Mortgage Balance Residency Start Date Monthly Mortgage or Rent Payment

Employment

Employment Employed Not Employed

Employment Start Date Position or Title Annual Income Name of Employer Employer's Address City State Zip Code Employer's Phone Number

Have you worked here for more than two years? (No if unemployed) Yes No

Previous Employer (if less than two years at current)

Employment Start Date Position or Title Gross Monthly Income Name of Employer Employer's Address City State Zip Code Employer's Phone Number

Other Income

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

Amount Desciption

Financial Information

Do you have a checking account? Yes No

Checking Account Number Financial Institution Cash/Market Value

Do you have a savings account? Yes No

Savings Account Number Financial Institution Cash/Market Value

Co-Applicant

First Name Middle Initial Last Name Suffix Social Security Number Birth Date Home Address City State Zip Code

Have you lived at this address for 2 or more years? Yes No

Previous Home Address City State Zip Code

Mailing address is different than street address. Mailing Address City State Zip Code Home Primary Number Work Phone Number E-mail Address Please do NOT email me important news and updates.

How would you prefer to be contacted? Home Phone Work Phone Email Other

Other Preference

Citizenship

Citizenship U.S. Citizen Permanent Resident Alien Non-Resident Alien

Marital Status

Housing Status Married Separated Unmarried (include single, divorced, widowed)

Dependents

Number of Dependents Age of Dependents (Separated by Comas)

Housing Status

Housing Status Own Rent Other

Explain Estimated Property Value Mortgage Balance Residency Start Date Monthly Mortgage or Rent Payment

Employment

Employment Employed Not Employed

Employment Start Date Position or Title Annual Income Name of Employer Employer's Address City State Zip Code Employer's Phone Number

Have you worked here for more than two years? (No if unemployed) Yes No

Previous Employer (if less than two years at current)

Employment Start Date Position or Title Gross Monthly Income Name of Employer Employer's Address City State Zip Code Employer's Phone Number

Other Income

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

Amount Desciption

Financial Information

Do you have a checking account? Yes No

Checking Account Number Financial Institution Cash/Market Value

Do you have a savings account? Yes No

Savings Account Number Financial Institution Cash/Market Value

Endorsement

I/We hereby apply for the loan or credit described in this application. I/We certify that I/We made no misrepresentations in this loan application or in any related documents that all is true and complete, and that I/We did not omit any important information. I/We agree that any property securing the loan or credit will not be used for any illegal or restricted purpose. Lender is authorized to verify with other parties and to make any investigations of my/our credit, either directly or through any agency employed by lender for that purpose. Lender may disclose to any other interested parties information as to lender’s experiences or transactions with my/our account. I/We understand that lender will retain this application and any other credit information lender receives, even if no loan or credit is granted. These representations and authorizations extend not only to lender, but also to an insurer of the loan and to any investor to whom lender may sell all or any part of the loan. I/We further authorize lender to provide to any such insurer or investor any information and documentation that they may request with respect to my/our application, credit or loan.

Type the numbers you see above: Applicant's Signature Date Co-Applicant's Signature Date