Charitable Bank Loan Authorization
Authorization Details
Charitable Bank Name
*
Who is submitting this loan authorization request?
*
Manager of the Company
Authorized Representative (Not the Manager)
Representative
Representative
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Manager
Manager
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Did you change your address
*
Yes
No
Mailing Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Borrower
Borrower
Borrower Type
*
Individual
Business Entity
Borrower Company
*
Borrower Name
*
Borrower Title
*
Qualification
Qualification
Annual Business Revenue
*
Annual Personal Income
*
Credit Score Range
*
800–850 (Excellent)
740–799 (Very Good)
670–739 (Good)
580–669 (Fair)
300–579 (Poor)
Loan Details
Loan Details
Have you already taken out this loan?
*
No
Yes
Loan Amount
*
Loan Start Date
*
-
Month
-
Day
Year
Date
Additional Information
Additional Information
Please share any questions or concerns: (optional)
Certification and Authority
*
I certify under penalty of perjury that the information provided is true and correct and that I have the authority to submit this request.
Submit
Should be Empty: