Loan Application Form

Sample Partial Preview Of Loan Application

LENDER NAME

LOAN APPLICATION

Section A

You must answer YES to the following Questions to continue:

Are you an _____________ citizen or a permanent resident?                                                                                               Yes / No

Are you over 18 years of age?                                                                                                                                           Yes / No

Do you have a regular income?                                                                                                                                         Yes / No

Is the loan amount between $3,000 and $50,000?                                                                                                           Yes / No

Are you NOT an undischarged bankrupt or subject to bankruptcy proceedings?                                                  Yes / No

Do you agree to answer the Q’s accurately and truthfully?                                                                                         Yes / No

You must answer NO to the following Questions to continue:

Do you have any current loans or credit cards in arrears or over their limit within the last 6 mths?      Yes / No

Have you applied 3 or > times for other loans/credit within the last month?                                             Yes / No

Section B – Loan Purpose and Amount

Please list ALL the reasons why you require this personal loan:

Reason                                           Payee (if known)                                    Amount

________________________                        __________________            $____________

________________________                        __________________            $____________

________________________                        __________________            $____________

________________________                        __________________            $____________

How many applicants will be applying for this loan?  One / Two (circle one)

Total loan amount being applied for: $_______________ Deposit Amount: $_____________

Preferred term of loan:  36 / 48 / 60 / 72 / 84 months (circle one)

Section C Applicant Details