Loan Application Worksheet Page 2
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2L OAN AP P L I C AT IO N W OR KS HE ET
REFERENCE # 1
Name:
Current address:
City:
State:
ZIP Code:
Phone #
Relation to you:
REFERENCE # 2
Name:
Current address:
City:
State:
ZIP Code:
Phone #
Relation to you:
LOAN INFORMATION
Have you ever defaulted on a student loan?
Yes
No
How long would you like the payments to run?
2yrs
3yrs
5yrs
10 yrs
15yrs
Would you like to defer the payments?
3 months
6 months
12 months
OTHER ASSETS OR SOURCES OF INCOME (ALIMONY/CHILD SUPPORT ETC.)
Description:
Amount per month or value
Description:
Amount per month or value
Comments:
SIGNATURE
Signature:
Date:
**ALL ITEMS IN BOLD ARE REQUIRED FIELDS**
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Parent category: Business