GreenSky Installment Loan Information Form - Chicagoland Exteriors
GreenSky? Installment Loan Information Form
By submitting a loan application, you, the applicant, and co-applicant (if any) agree that you are applying for any product that any financial institution participating in the GreenSky? Program (a "Lender") may offer as part of the GreenSky? Program,
regardless of any product your merchant may have specifically discussed with you. The information from this form will be used to submit an application for a GreenSky? Program loan via the Program's computer application.
Borrower Information
First Name*
Middle Initial
Last Name*
Requested Loan Amount (if known):
Date of Birth (mm/dd/yyyy)
/
/
Social Security Number*
Home Phone*
Mobile Phone (See Disclosure)
Borrower Street Address*
(Physical address required. No P.O. Boxes)
Suite/Apt #
City*
State*
Zip Code*
Email Address
(If you provide an email address, GreenSky may use it to contact you about GreenSky? products, services, special offers and other promotions)
Employer
Years on the Job*
Employer Phone Number
If Borrower is retired, enter "Retired" in the Employer field, enter "0" in the Years on Job field and enter the Borrower's home phone number. If Borrower is unemployed, enter "Unemployed" in the Employer field, enter "0" in the Years on Job field and enter the Borrower's home phone number.
Income
Alimony, child support or separate maintenance payments need not be revealed if you do not wish to have them considered as a basis for repaying the loan. Married Wisconsin Residents: Combine you and your spouse's information once.
Applicant's Gross YEARLY Income ($)*
Other Gross YEARLY Income ($)
Examples: yearly salary (before taxes) alimony, child support, investment income, social security, etc.
Examples: Co-Borrower and/or spousal income (before taxes), alimony, child support, investment income, social security, etc.
Co-Borrower Information
First Name*
Social Security Number*
Middle Initial
Last Name* Home Phone*
If completed below, Borrower and Co-Borrower intend to apply for joint credit.
Date of Birth (mm/dd/yyyy)
/
/
Mobile Phone (See Disclosure)
Co-Borrower Street Address* City*
(Physical address required. No P.O. Boxes)
Suite/Apt # State*
Zip Code*
Email Address
(If you provide an email address, GreenSky may use it to contact you about GreenSky products, services, special offers and other promotions)
Employer*
Years on the Job*
Employer Phone Number*
If Co-Borrower is retired, enter "Retired" in the Employer field, enter "0" in the Years on Job field and enter the Co-Borrower's home phone number. If Co-Borrower is unemployed, enter "Unemployed" in the Employer field, enter "0" in the Years on Job field and enter the Co-Borrower's home phone number.
Married Wisconsin Residents
Borrower Spouse's First Name:* Borrower Spouse's Street Address:* City* Co-Borrower Spouse's First Name:* Co-Borrower Spouse's Street Address:* City*
Middle Initial Suite/Apt # State* Middle Initial Suite/Apt # State*
Borrower Spouse's Last Name:* Zip Code* Co-Borrower Spouse's Last Name:*
Zip Code*
Please see Disclosures and signatures continued on the next page
Use this information to submit an application at consumer
* Indicates that the field information must be included
Effective 12/01/2016
GSCP Installment Application Page 1 of 2
LICENSES: NMLS #1416362; CT SLC-1416362; NJ MT #1501607 C22
Effective December 1, 2016
TO BE COMPLETED BY SALES CONSULTANT/MERCHANT
GSCP Installment Application Page 2 of 2
Merchant Number
Borrower Type of ID
Plan Number [ ] Driver's License [ ] State/Province Issued ID [ ] Military ID [ ] Passport [ ] Tribal Card (please check one)
Borrower Name on ID
Co-Borrower Type of ID
State of Issuance ID Number
ID Expiration Date
[ ] Driver's License [ ] State/Province Issued ID [ ] Military ID [ ] Passport [ ] Tribal Card (please check one)
Co-Borrower Name on ID
Sales Associate/Merchant
State of Issuance ID Number
ID Expiration Date
Name
Phone Number
Email Address
Disclosures
By submitting an application, you agree that you are applying for any product that any financial institution participating in the GreenSky? Program (a "Lender") may offer as part of the GreenSky? Program, regardless of any product your merchant may have specifically discussed with you. THE FOLLOWING IS IMPORTANT INFORMATION ABOUT PROCEDURES FOR OPENING A NEW ACCOUNT: To help the government fight the funding of terrorism and money laundering activities, Federal law requires all financial institutions to obtain, verify, and record information that identifies each person who opens a new account. What this means for you: When you open an account, we will ask for your name, address, date of birth, and other information that will allow us to identify you. We may also ask to see your driver's license or other identifying documents.In addition, the following notices, disclosures, and authorizations apply to your application. Alimony, child support, or separate maintenance payments need not be revealed if you do not wish to have them considered. By submitting an application for credit, you certify the following: (1) all of the statements (whether verbally or written) communicated to us, or to your merchant, are true and correct, and are made for the purposes of obtaining credit; and, (2) if more than one applicant is applying, each applicant intends to apply for joint credit and none is a co-signer (a "co-signer" is a person who agrees to be liable for the debt of another person without receiving the benefit of the loan, whereas a "joint applicant" is a person who intends to apply for joint credit and will receive the benefit of the loan; although we allow joint applicants to apply for joint credit, we do not allow borrowers to use "co-signers"). In addition, you authorize the GreenSky? Program, on behalf of the Lenders participating in the Program, to (1) obtain a credit report on you for any legal purpose in connection with this loan application, including any account update, extension of credit, or review or collection of your loan; and, (2) notify your merchant of our credit decision, including your credit score, and if approved, the credit decision and loan information, including, but not limited to, your approved credit limit, the repayment period for your loan, your approved APR, and account number. If you request, you will be informed whether a credit report was requested and, if so, the name and address of the consumer reporting agency that furnished this report. You also agree to provide additional financial information upon request. By submitting a loan application, you expressly authorize the shared disclosure of loan related information, including but not limited to, your credit decision, proposed loan terms, and personal credit scores to any co-applicant, which will have the same effect as personal delivery to you. Also, if you provide an email address, we, and or the merchant, may use it to contact you about our products, services, special offers and other promotions. Where applicable, you will be charged a one-time Account Activation Fee of $39 at the time of first purchase. Mobile Number: If you choose to provide a mobile number, the following applies: you authorize GreenSky? to contact you at this mobile number using text messages, an automated telephone dialing system, or artificial or prerecorded voice messages, for any purpose, including, but not limited to, delivering advertisements or telemarketing messages. You are not required to provide consent as a condition of this loan application. You may provide another phone number or revoke your consent at any time by contacting GreenSky? at P.O. Box 29429, Atlanta, GA 30359. Finally, upon loan approval, a Shopping Pass will be issued to you. Use of your Shopping Pass or your installment loan to make a purchase, whether in store, online, on the telephone, through your merchant, or otherwise by any borrower authorized on the loan agreement, will constitute acceptance of the loan and the loan agreement governing the Shopping Pass by all borrowers. The physical and electronic records of any such purchase will constitute the signature of all borrowers on the loan agreement. NOTICES: California Residents: If you are married, you may apply for a separate account. Ohio Residents: The Ohio laws against discrimination require that all creditors make credit equally available to all credit worthy customers, and that credit reporting agencies maintain separate credit histories on each individual upon request. The Ohio civil rights commission administers compliance with this law. Vermont Residents: We are engaged in loan production. Your submission of a credit application is your written instructions to obtain a consumer credit report. A consumer credit report may be requested in connection with this application or in connection with updates, renewals or extensions of credit granted as a result of this application. Upon your request, you will be informed whether or not such a report was requested and, if so, the name and address of the agency that furnished the report. Married Wisconsin Residents: If you are apply for individual credit or joint credit with someone other than your spouse, and your spouse also lives in Wisconsin, combine your financial information with your spouse's financial information. No provision of any marital property agreement, unilateral statement under Section 766.59 of the Wisconsin statutes or court order under section 766.70 adversely affects the interest of the lender, unless the lender, prior to the time credit is granted, is furnished a copy of the agreement, statement of decree or has actual knowledge of the adverse provision when the obligation to the lender is incurred. If married, you understand that your lender must inform your spouse if a credit account is opened for you.
Borrower Signature
X Borrower's Signature
Co-Borrower Signature
X Co-Borrower's Signature
LICENSES: NMLS #1416362; CT SLC-1416362; NJ MT #1501607 C22
Date Date
Please provide a government issued picture ID to the Associate/Merchant.
If signed, Borrower and Co-Borrower intend to apply for joint credit.
Please provide a government issued picture ID to the Associate/Merchant.
Online: ? Email: service@ ? 866-936-0602
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