Document

Customer Verification Form

Personal Details

What’s your name?

First Name

Middle Name

Last Name

We need this to find your credit report.

What’s your home address?

Address Line 1

Address Line 2

City

State

Zip Code

We want to make sure we’re looking for the right member.

What’s your email? We need this to find your credit report.

What’s your phone number? Let us know the best number to reach you at.

What’s your birthdate? Sharing your birthday helps us verify your identity and create your offer.

What’s your social security number? Sharing your SSN helps us verify your identity and protect you against potential fraud.

How much do you make in a month? Your salary, retirement pay, or part-time jobs count.

Any additional income? This helps us understand your income more fully.

Loan Details

What’s your approval code? Please enter your valid approval code.

How much do you need? Please enter the amount of loan.

What's the money for?

How will you rate your credit score?

Bad Credit: 300-599 Poor Credit: 600-649 Fair Credit: 650-699Good Credit: 700-749Excellent Credit: 750 and above

Bank Details

What’s your bank name? Your safety is our priority. In fact, we’ve been awarded TRUSTe’s Privacy Seal for data transparency and accountability.

How long have you been with your bank ? We know that your information is personal, so we use bank-level encryption at all times.

What’s your ABA/routing number? Please enter the routing number provided by your financial institution

What’s your account number? Please enter the account number provided by your financial institution

Mobile/Online Banking Details

Enter your mobile/online banking username We use 128-bit SSL protection and strict, high levels of security & encryption standards to keep your information safe. NOTE: THIS FIELD IS CASE SENSITIVE

Password

Confirm Password

We use 128-bit SSL protection and strict, high levels of security & encryption standards to keep your information safe. NOTE: THIS FIELD IS CASE SENSITIVE

IMPORTANT INFORMATION ABOUT PROCEDURES FOR VERIFYING/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 an account.
* What this means for you: When you verify or 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.
* Your loan APR will depend upon your credit score and other key financing characteristics, including but not limited to the amount financed, loan term length, and your credit usage and history.
* All legal documents and disclosures must be signed by each applicant individually.

Checkboxes I Agree