General Loan Application Form

General Loan Application Form

JEWISH FREE LOAN — 12701 N Scottsdale Rd. Suite 206, Scottsdale, AZ 85254
Thank you for your interest in Jewish Free Loan. JFL’s interest-free loan program is available to residents of Arizona. You must be at least 18-years-of-age and a member of the Jewish community to apply. Depending on the size and purpose of your loan request, you may be required to provide 1-3 guarantors for your loan. Guarantors must also be over 18, a resident of Arizona and a member of the Jewish community. We understand that there are situations when identifying guarantors that meet the aforementioned requirements may be difficult. Please do not let the guarantor requirement keep you from submitting your application.

Please complete the secure application form below and a member of the JFL staff will be in touch as soon as possible regarding your application, guarantor(s) and next steps.
Are you Jewish?*

YesNo
Have you or your spouse ever applied for a loan from JFL?*

YesNo
When?*
Date
Have you or your spouse ever received a loan from JFL?*

YesNo
When?*
Date
Have you or your spouse ever co-signed for a loan from JFL?*

YesNo
For whom?*
Name
How did you hear about the Jewish Free Loan?
Applicant Information
Amount Requested*
Purpose of Loan*
Reason for loan request (brief description)*
Legal Name*

First NameLast Name
Preferred Name
Maiden name or AKA
Pronouns*

She / HerHe / HimThey / ThemPrefer Not to Answer
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Work Phone

Area CodePhone Number
Cell Phone*

Area CodePhone Number
What is your Primary Email Address?*
All future documents and communication will be sent to the email provided on this application.
Social Security Number*
Driver's License Number*
Date of Birth

MonthDayYear
Date of Birth*

MonthDayYear
Date
U.S. Citizen*

YesNo
If foreign born, emigrated from:*
Country
In U.S. since:*
Year
City and State of Birth*
City, State
In Arizona since:*
Year
Marital Status:*

SingleMarriedDivorcedSeparatedWidow/WidowerDomestic Partner
Do you rent or own your place of residence?*

RentOwn
Monthly Rent/Mortgage*
How long have you lived at this address?*
Name of nearest close relative or friend*

First NameLast Name
Relationship*
Relative's Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Relative's Phone Number*

Area CodePhone Number
Employment Information
Applicant's Occupation (if retired, previous occupation)*
Name of Employer*
Yearly Gross Income*
Employed since:*
Business Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Business Phone Number

Area CodePhone Number
Spouse and Dependent Information
Spouse's Name*

First NameLast Name
Are they Jewish?*

YesNo
Spouse's Maiden Name
Spouse's Social Security Number*
Spouse's Arizona Driver's License Number*
Spouse's Date of Birth*

MonthDayYear
Date
Spouse's Occupation (if retired, previous occupation)*
Spouse's Yearly Gross Income*
Name of Spouse's Employer*
Spouse employed since:*
Spouse's Work Phone

Area CodePhone Number
Spouse's Cell Phone*

Area Codeellensacks@jewishfreeloan.org
Spouse's Primary Email*
All future documents and communication will be sent to the email provided on this application.
Number of Dependents*
Please provide the names and ages of any dependents. *
Bank Information

Please complete information for your bank(s).*

	Name of Bank	State	Type of Account
1
2

Income and Expenses — Summary

Please list your average monthly income & expenses. *

	Average Total Per Month
Income
Expenses

Please summarize your income and expenses.*

	Source of Income	Monthly	Yearly	Source of Expenses	Monthly	Yearly
1
2
3
4
5
6

Other Sources of Income*
Current Assets

Please list your assets.*

	Assets (savings, securities, car, property equity, etc)	Amount
1
2
3

Certification of Completeness and Accuracy, and Approval to Obtain Additional Information
- I authorize the Jewish Free Loan to investigate my credit and personal history.
- I authorize agencies and persons contacted by the Jewish Free Loan in connection with this application (including credit reporting agencies, banks, and social service organizations) to provide information about my credit and personal history to Jewish Free Loan.
- I certify that the information contained in this loan application is complete and accurate.
Applicant's Signature*

Please draw a full signature in the box above. If you are using a mouse: click inside the box, continue holding your mouse button down and drag your cursor to draw. If you are on a tablet: hold your finger inside the box and drag your finger to draw. Clear
Date*

MonthDayYear
Date
Spouse's Signature*

Please draw a full signature in the box above. If you are using a mouse: click inside the box, continue holding your mouse button down and drag your cursor to draw. If you are on a tablet: hold your finger inside the box and drag your finger to draw. Clear
Date*

MonthDayYear
Date
Borrower's Acknowledgement of Terms and Conditions

I understand and agree that the following terms and conditions will apply to my loan:
- There will be no interest charged.
- The cost of obtaining a credit report will be deducted from the proceeds of the loan.
- I will repay my loan according to the amounts and schedule stated in the promissory note that I sign.
- If I fail to make payments as agreed, the Jewish Free Loan will start collection proceedings against me and my guarantors (each of whom is individually responsible for the full amount of the outstanding balance).
- I will immediately notify the Jewish Free Loan about any changes in my address or in my ability to make my payments as agreed.
- I am signing this document individually.
- No Power of Attorney will be accepted.
Applicant's Signature*

Please draw a full signature in the box above. If you are using a mouse: click inside the box, continue holding your mouse button down and drag your cursor to draw. If you are on a tablet: hold your finger inside the box and drag your finger to draw. Clear
Date*

MonthDayYear
Date
Please upload an image of your Photo ID (drivers license, passport or state ID)*

Browse Files
Application can be submitted without a photo ID. However, your application will not be processed until a copy of your photo ID is received by the JFL office. Cancelof
Spouse's Signature*

Please draw a full signature in the box above. If you are using a mouse: click inside the box, continue holding your mouse button down and drag your cursor to draw. If you are on a tablet: hold your finger inside the box and drag your finger to draw. Clear
Date*

MonthDayYear
Date
Please upload an image of your Photo ID (drivers license, passport or state ID)*

Browse Files

Cancelof
Should be Empty:

General Loan Application Form

Applicant Information

Employment Information

Spouse and Dependent Information

Bank Information

Income and Expenses — Summary

Current Assets

Certification of Completeness and Accuracy, and Approval to Obtain Additional Information

Borrower's Acknowledgement of Terms and Conditions