NOIR LENDING CDFI INC. LOAN APPLICATION

LOAN APPLICATION

EASIER ACCESS TO CAPITAL
Application Date*

MonthDayYear
Date
Applicant Details
Full Name*

First NameLast Name
Social Security Number*
Date of Birth*

MonthDayYear
Date
Gender*

MaleFemale
Race*

American Indian or Alaska NativeAsianBlack or African AmericanNative Hawaiian or Other Pacific IslanderWhiteOther
Ethnicity*

Hispanic or LatinoNot Hispanic or Latino
Phone Number*
Email*
example@example.com
Type of ID you would like to present?*
Upload Current ID*

Cancelof
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Type of Residence*

OwnedRentedLiving with FamilyOther
How many years have you been staying in this residence?*
Civil Status*

SingleMarriedDivorcedWidowed
If married, please enter the name of the spouse

First NameLast Name
Spouse phone number
Number of dependents*
Employment Details
Source of Income*

EmployedSelf-EmployedOther
Employment History 5-years*
Monthly Gross Income ($)*
Annual Gross Income ($)*
Other Sources of Income*
Total amount of monthly payments (including rents/expenses etc.)*
Loan Details
Type of loan applying for?*

Credit Builder Loan ($500)Small Dollar Consumer Loan (up to $2,500)
Credit Score?*
Requested loan amount?*
Loan Terms*

1 year2 years3 yearsOther
Reason for Loan*
References

List of References*

LOAN APPLICATION