Customer Contact Sheet - OneMain Financial

Customer Contact Sheet

Customer Name: __________________________________________________________________________________________________________

Date:

__________________________________________

Please provide alternate contacts not residing with you. In the event that you do not inform our company of your current address, telephone number, and

employer, we will attempt to contact you using the information below. Please note that this information will not be used for solicitation purposes.

Contact Name

Street Address, City, State, Zip

Home Phone Number

Cell Phone Number

Relationship

I acknowledge that I am providing this information voluntarily to be used in accordance with the statements above. Loan approval is not contingent upon my

completion of this document. My personal account information will not be shared.

____________________________________________________________________________________

Customer Signature

_________________________

Date

usomUS1232OLM

1/19/2016

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