Borrower's Information

Personal Information

Family Size

Employment Status

Business Information

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Business Information Continued

If loan is approved, how many employees do you estimate to hire in the next 12 months?

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Detailed Loan Information

Have you ever received any other loan for your business before?

Have you had any late loan payments within the last six months?

Have you stopped making payment or defaulted on any credit accounts within the last six months?

Credit Score

Bank information for my monthly ACH loan payment:

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Upload Documents

This form offers an upload feature for both a file and for an image with a maximum size of 3 megabytes.

Acceptable file types are .pdf, .docx, .doc, .odt, .rtf, .txt.

Acceptable image types are: .png, .jpg, .jpeg.

Personal Bank Statements

Please upload your bank statements from the last three months, verifying stated income. (If income does not show in your bank statement, please also submit a copy of your pay stub.)

Business Income Documents

Please upload your bank statements from the last three months, and other documents showing business income.

Credit Score

Please upload a copy of your credit score.

Credit Report

Please upload your credit report. You can access a copy of your free credit report at www.annualcreditreport.com.

Please upload a copy of void business check or a similar document that includes name, routing and account number. (If business account is not available, you can submit personal checking info.) If approved, this account will be used for loan disbursement.

Tax Returns

Please upload your personal tax returns from the last two years. This is required for Line of Credit and Auto Loan applicants, or if applicable, to show proof of income.

Please upload your Business tax returns from the last two years. This is required for Line of Credit and Auto Loan applicants, or if applicable, to show proof of income.

Please upload a copy of your Drivers License/ID

If you are not a US citizen or permanent resident, please attach Employment Authorization form or a copy of social security card.

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Socio-Economic Information

Life Asset values equality and does not discriminate on the basis of race, color, creed, sex, age, national origin, handicap, sexual orientation, or any other classification protected by applicable state or federal discrimination laws.

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Other

Group Lending

Group Members (NOT required for line of credit, auto loan, or secured credit building loan applicants. Enter N/A if not applicable.)

I am ready to submit my loan application. I certify that, to the best of my knowledge and belief, all information contained in this loan application and in the accompanying statements and documents is true, complete, and correct. I agree to notify Life Asset immediately of any material changes in this information. I understand that Life Asset may request additional information. Due to the individual circumstances for each loan, your loan officer might ask for further details to provide you with the best possible service. I authorize Life Asset to check my credit history, including verification of the information on this loan application.

I agree to receive important notifications, updates, and information regarding my account or services via email and text messages. I understand that message and data rates may apply for text messages and that I may opt out of receiving these communications at any time by following the instructions provided in the communications.

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Further Information

Is there anything else you would like to share about the impact of your loan with Life Asset? This includes anything related to the program or your work with Life Asset's employees and volunteers.

For Life Asset Use Only (below is to be filled out by Life Asset):

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Thank You, we will be in touch!