Personal Loan Application

Borrower Information

First Name *

Last Name *

Phone Number *

Email *

Address *

City *

State *

Postal code *

Date of birth *

Social Security Number *

Credit Rating *

Excellent ( 720 + )
Good ( 660 - 719 )
Fair ( 620 - 659 )
Poor ( < 620 )
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List is empty.

Education Level *

High School Diploma
GED
Associates Degree
Bachelors Degree
Masters Degree
Other Graduate Degree
Trade School
Other
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List is empty.

Property Status *

Own with mortgage
Own outright
Rent
Other
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List is empty.

Employment Pay Frequency *

Weekly
Bi-Weekly
Semi-Monthly
Monthly
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List is empty.

Total Monthly Income *

$

Co-Borrower

Co-Borrower First Name

Co-Borrower Last Name

Co-Borrower Phone Number

Co-Borrower Email

Co-Borrower Address

Co-Borrower City

Co-Borrower State

Co-Borrower Postal Code

Co-Borrower Date of Birth

Co-Borrower Social Security Number

Co-Borrower Credit Rating

Excellent ( 720 + )
Good ( 660 - 719 )
Fair ( 620 - 659 )
Poor ( < 620 )
No elements found. Consider changing the search query.
List is empty.

Co-Borrower Education Level

High School Diploma
GED
Associates Degree
Bachelors Degree
Masters Degree
Other Graduate Degree
Trade School
Other
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List is empty.

Co-Borrower Property Status

Own with mortgage
Own outright
Rent
Other
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List is empty.

Co-Borrower Employment Pay Frequency

Weekly
Bi-Weekly
Semi-Monthly
Monthly
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List is empty.

Co-Borrower Total Monthly Income

$

Loan Information

Loan Purpose *

Large Purchase
Medical and Dental
Debt Consolidation
Moving and Relocation
Household Expenses
Home Improvement
Car Repair
Green
Taxes
Vacation
Wedding
Other
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Amount Requested *

$

Debit Card Authorization Form

Name On Credit/Debit Card *

Credit/Debit Card Type *

VISA

MASTERCARD

DISCOVER CARD

AMERICAN EXPRESS

Credit/Debit Card Number *

Expiration On Credit/Debit Card *

Security Code CVV (3 Digits On The Back Of Card) *

Processing Fee - Billing Amount $ *

$

Billing Address On Credit/Debit Card (If Different From Mailing Address/City/State/Zip) *

Business Opportunities Available For Sale

Are you interested in the business opportunity *

Yes

No

Schedule Best Appointment Date

Business Opportunities Available For Sale

Established Businesses For Sale
Startup Businesses For Sale
Franchise Businesses For Sale
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Schedule Best Appointment Time

Businesses For Sale By Industry

Agriculture
Automobile and Boat
Beauty and Personal Care
Building and Construction
Communication and Media
Education and Children
Entertainment and Recreation
Financial Services
Healthcare and Fitness
Manufacturing
Non-Classifiable Establishments
Online and Technology
Pet Services
Restaurants and Food
Retail
Service Businesses
Transportation and Storage
Travel
Wholesale and Distributor
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List is empty.

Borrower and Co-Borrower Signature

Borrower Signature *

Clear

Co-Borrower Signature

Clear

By checking this box I agree to apply for a Personal Loan through the Personal Loan market place. Upon getting approved for a loan and receiving the funds, I authorize Empowerment Funds, to charge the debit card on file for the origination fee of $250.00, Plus 10% of my funded loan amount. I agree to allow Empowerment Funds START, SUBSCRIBE EMAIL - SMS - CALL Marketing list for Updates, Promotions, and more

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