If married, you have the right to apply ... - Personal Loan

If married, you have the right to apply for credit separately from or jointly with your spouse. *Information is not required.

date

application taken by

amount applied

purpose of loan

$ q office for over

q phone pres. bal.

credit

bureau score

loan application community lenders is an equal opportunity lender referred by (please print)

q newspaper

applicant's last name

1st name

m.i. or name

age

app. birth date

co-applicant last name

source

application no.

q phone book

q other:

1st name or initial

m.i. or name

mailing address

city

state

zip code

phone no.

cell no.

time at residence

previous address

time at residence

co-applicant address

cell no.

time at residence

applicant employed by

occupation

phone no.

ext.

time at poe

applicant's previous employer

occupation

yrs.

mo.

applicant's social security no.

co-applicant employed by - address and location

occupation

phone no.

ext.

co-app. birth date

app. gross mo. salary

$

co-app. time at poe

co-applicant's previous employer

occupation

yrs.

mo.

co-applicant's social security no.

all other sources of income (explain)

other income

mortgage co.

landlord

q buy q rent

second mortgage holder and address

phone

#1 auto year - make - model

mileage

#2 auto year - make - model

mileage

q financed q paid

co-app. gross mo. salary

$

total mo. gross income

$ 0

rent / 1st mtg. pmt.

$

2nd mtg. pmt.

$

q financed q paid

#3 auto year - make - model

mileage

#4 auto year - make - model

mileage

q financed q paid

q financed q paid

bank or savings & loan association (name & address) q checking q savings

auto insurance co.

other assets - boat, motorcycle, atv, etc.

are you open with any payday or quick cash loan companies?

q yes q no

creditor

payment

balance

p / o

collateral

rating

creditor

payment

balance

p / o

collateral

rating

1. community lenders

11.

2.

12.

3.

13.

4.

14.

5.

15.

6.

16.

7.

17.

8.

18.

9.

10.

19. totals

$ 0

$ 0

$0

Applicant's Signature_ ________________________________________ Date____________________________ Co-Applicant's Signature______________________________________ Date____________________________

Everything stated in this application is correct to the best of my knowledge, I/we understand that you will retain this application whether or not it is approved. I/We hereby authorize Community Lenders to obtain a credit report on me/us and to contact past, current and future employers to verify employment, salary information and residence. I authorize you to send me information from time to time about services you offer. If I do not wish to receive this information, I will contact you and you will remove my name from your mailing list.

employment and income verification

how paid:

D how ate employed_______________________________________ gross income: $_ __________________________________ verified

applicant

coapplicant

occupation__________________________________________ misc_________________________________________________ date employed_______________________________________ gross income: $_ __________________________________ occupation__________________________________________ misc_________________________________________________

customer identification

(Show how you identified the Customer)

applicant

co-applicant

1st id

type

(Picture ID, Drivers Lic, etc)

2nd id

type

(Picture ID, Drivers Lic, etc)

collateral comments

reason customer was qualified for loan or reason loan was not made approved / denied

max. loan amount

$

manager approval:

glc amount

$

date(s)

every other week:

$ _____________ x 5226 = $ _0____________ + 12 = $ _1_2___________

gross

sub total

mo. gross

paid weekly:

$ _____________ x 52 = $ _0____________ + 12 = $ _1_2___________

gross

sub total

mo. gross

paid hourly:

$ _____________ x _____________ = $ _0____________

hourly rate

# hrs. worked

sub total

x 52 = $ _0____________ ? 12 ....................... $ _____________

sub total

mo. gross

capacity analysis

$ 0 1. monthly gross income $ 0 1st mortgage rent payment

2. on residence

+ $ 0 total of all other mo. payments

3. not being consolidated

4.

+ $

5.

+ $

proposed monthly payment

6. to community lenders

+ $

total monthly obligation

7. (sum of 2 thru 6)

= $0

8. $ gross income amount remaining (1 minus 7)

$ final computations

(totals)

asset analysis

security

$ schedule of pers prop $ auto #1 trade in value $ auto #2 trade in value $ other

$ sub total $

0 $ total

budget value

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