LENDING HAND INC. SMALL LOAN APPLICATION

LENDING HAND INC.

SMALL LOAN APPLICATION

Individual Application: Only Applicant will be obligated under the Revolving Loan Account Agreement

PLEASE PRINT

Name ________________________________________________________________________________________

LAST

FIRST

M.I.

ADDRESS _____________________________________________________________________________________

STREET

CITY

STATE

ZIP

HOW LONG AT ADDRESS _________ HOME PHONE ___________________ CELL NUMBER ____________________

SOCIAL SECURITY # _____________________________ DATE OF BIRTH ___________________________________

EMPLOYER _________________________________________________ WORK PHONE _______________________

ADDRESS _____________________________________________________________________________________

STREET

CITY

STATE

ZIP

HIRE DATE _________________ DEPT _____________________FREQUENCY OF PAY ________________________

GROSS PAY (Before taxes) _________________ DAY PAID ON ______________ NEXT PAYDAY ___________________

Do you have any outstanding small loans with this lender (including any small loans made at any other offices of this lender? ______Yes ______No Do you have any outstanding small loans with any other payday lender(s)? ______Yes ______No If the answer above is yes:

How many? ________One _______Two or more Name of other Lender(s)_____________________________ Have you ever filed bankruptcy? ______Yes _____No Do you presently have a checking account ______Yes _____No How did you hear about us? ______________________________________

Bank Name____________________________________ Account # ________________________________

Personal References NAME

PHONE

RELATIONSHIP

_____________________________________________________________________________________________

_____________________________________________________________________________________________

_____________________________________________________________________________________________

BY SIGNING THIS LOAN APPLICATION YOU HEREBY CERTIFY THAT ALL OF THE FOREGOING INFORMATION IS TRUE AND CORRECT TO THE BEST OF YOUR KNOWLEDGE. WARNING: KNOWINGLY ORINTENTIONALLY MAKING A FALSE OR MISLEADING STATEMENT ON THIS LOAN APPLICATION MAY CONSTITUTE A CRIMINAL OFFENSE.

Applicant's Signature _______________________________________________________Date ________________

 ................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download