How did you find this website? * Amount of Loan Requested: * Purpose of Loan: * Name (Last, First, Middle): * Social Security Number: * Date of Birth: * E-mail Address: * Residental Address (RR#, Street, Apt #, City, State & Zipcode / APO or FPO): Years at Present Address: * Do You Rent or Own?: * Years at present address: * Landlord Name/Mortgage Co. (Verification): * Landlord/Mortgage Co. Phone Number: * Postal installation where employed: * Duty position: * Work section/unit: * 1st Line Supervisor's Grade, Name and Telephone Number: * Employer Address (RR#, Street, Apt #, City, State & Zipcode / APO or FPO): * Date of hire: * Finance number: * Career status: * Home Phone Number: * Cell Phone Number: * Work phone number: * Facimile (FAX) Number: * Postmaster name: * Postmaster phone number: * Name of Spouse: * Number of Dependents: * Do You Have a Checking Account?: * Do you have direct deposit? * Bank name: * Account number: * Are You Willing to Open an Allotment with Us?: * Number of current allotments: * What is your bi-weekly take home (Net) pay? * Other Income Amount / Source: (Alimony, child support, separate maintenance income need not be revealed if you do not wish to have it considered as a basis for replaying this obligation.) * Have You Filed for Bankruptcy in the last ten years?: * Bankruptcy Discharge Date (Month/Year): * Paycheck Direct Deposit to (Bank/Credit Union): * * Account Number (if Checking - routing/account): * COLLATERAL AND MONTHLY EXPENSES SHEET
In order to process your loan we must have sufficient collateral to cover the loan. If you do not list collateral and provide the necessary information regarding the collateral, we will not be able to process your application.
Our general guidelines for small loans are as follows:
$100.00 to less than $1,000.00 requires personal property, such as electronic equipment, musical instruments, sports equipment, power tools, lawn power tools, camera equipment.
$1,000.00 to $3,000.00 requires a vehicle as collateral. If your vehicle is financed, we will need a copy of the Title Application denoting first lienholder and Registration faxed to us. If it is not financed, we will need you to fax/e-mail a copy of the Registration and a copy of the Title to be used as security.
We use only property authorized by the Federal Trade Commission Regulation Rule, Title 16, Code of Federal Regulations, Sec 411, 1 (d, household goods are defined in said rule are listed only when the security interest is to secure, the purchase, price of goods being purchased. Household goods are defined as: Clothing, furniture, appliances, one radio and one television, linens, crockery, kitchenware and personal effects (including wedding rings). The term does not include, works of art, electronic entertainment equipment (except one television and one radio), antiques and jewelry (except wedding rings).
Item: * Item: * Item: * Yr. Purchased: * Yr. Purchased: * Yr. Purchased: * Serial #: * Serial #: * Serial #: * Model #: * Model #: * Model #: * Value: * Value: * Value: * Vechicle Information (Make, Model, Year, VIN# and First Lienholder): * REFERENCES: (Family) Name: * Relationship: * Phone #: * Address: * Name: * Relationship: * Phone #: * Address: * Monthly Expenses: Rent: * Phone: * Car: * Childcare: * Water: * Cable: * Insurances: * Credit Cards: * Electricity: * Food: * Child Support: * DPP/AAFES: * List Allotments and Who Payed to: * Applicant(s) having first read this application, hereby execute(s) same on the application date shown above, certifies that applicant(s) is/are the legal age(s) to contract and that all of the above statements are true and complete and are made for the purpose of obtaining the credit applied for, warrants that the above statements fully represent applicant(s) income relied upon as the basis for repayment of the credit and total indebtedness, authorizes lender to communicate with applicant(s) or any person or corporation or governmental agency in connection with and during the pendency of this application or any credit granted, for the purposes of investigation of the references or statements listed above or other data obtained from applicant or for purposes of extension or review or collection of said credit granted and any further credit extension or solicitation, UNDERSTANDS THAT THE PURCHASE OF CREDIT LIFE AND/OR CREDIT DISABILITY INSURANCE is not required by Lender to obtain loan, understands that Lender must notify an applicant within 30 days as to approval or rejection of the application and can request Lender's reasons for the action taken. COVERED BORROWER IDENTIFICATION STATEMENT (Warning: It is important to fill out this form accurately. Knowingly making a false statement on a credit application is a crime.) I AM a regular or reserve member of the army, Navy, Marine Corps, Air Force, or Coast Guard, serving on active duty under a call or order that does not specify a period of 30 days or fewer. * I AM a dependent of a member of the Armed Forces on active duty as described above, because I am the member's spouse, the member's child under the age of eighteen years old, or I am an individual for whom the member provided more than one-half of my financial support for 180 days immediately preceding today's date. * I AM NOT a regular or reserve member of the Army, Navy, Marine Corps, Air Force, or Coast Guard, serving on active duty under a call or order that does not specify a period of 30 days or fewer (or a dependent or such member). * Don't Forget, yo u must FAX verification of all sources of income to 334-598-4019 or e-mail it to jfi@rapidloans.com before we can process your application.
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