Loan Application Form

Goolsby Financial Credit Application

Financing Your Future Starts Here Call us at (877) 377-0565. Completing this form does not guarantee approval, and Goolsby Financial may contact you for additional information.
Applicant Information
Full Name

First NameLast Name
Email Address
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Current Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Residence History
How long at current address (in years)
Housing status
Government ID details (do not provide the full identification number)
Loan Request Details
Requested Loan Amount (USD)
Loan Term
Preferred Monthly Payment
Applicant Employment
Current Employer
Job Title
Employer Phone
Please enter a valid phone number.Format: (000) 000-0000.
Employer Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Employment Start Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Years at Current Job
Annual Income (USD)
Other Income Amount (USD)
Source of Other Income
Upload Identification Document

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Upload Income Documentation

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Upload Most Recent Tax Return

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Co-Signer Information
Co-Signer Full Name

First NameLast Name
Will there be a co-applicant or co-signer?
Co-Signer Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Co-Signer Housing Status
Co-Signer Monthly Housing Payment (USD)
Co-Signer Employer Phone
Please enter a valid phone number.Format: (000) 000-0000.
Co-Signer Other Income (USD)
Co-Signer Bank Name
Co-Signer Bank Routing Number
Co-Signer Bank Account Number
Co-Signer - Have you ever declared bankruptcy?
Co-Signer - Have you ever had a foreclosure?
Co-Signer - Have you ever had a vehicle repossessed?
Co-Signer - Are there any judgments against you?
Co-Signer - Do you have any existing obligations not listed above?
Co-Signer Email Address
example@example.com
Co-Signer Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Co-Signer Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Co-Signer Current Employer
Co-Signer Job Title
Co-Signer Years at Current Job
Co-Signer Annual Income (USD)
Co-Signer Identification Document

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Co-Signer Income Documentation

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Co-Signer Most Recent Tax Return

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Consent and Authorization
Applicant Electronic Signature
Co-Signer Electronic Signature
Personal Information
Middle Name
Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Previous Address 1

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Previous Address 2

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Loan Request
Loan Purpose
Loan Type
Desired Term
Employment History
Previous Employer 1
Previous Employer 1 - From Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Previous Employer 1 - To Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Previous Employer 2
Source of Other Income
Previous Employer 2 - From Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Previous Employer 2 - To Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Other Income (USD)
Monthly Housing Payment (USD)
Banking and Financial Information
Bank Name
Account Type
Time with Bank
Bank Routing Number
Bank Account Number
Assets and Liabilities
Monthly Debt Payments
List of Assets
List of Liabilities
References

Please provide two personal references not living with the applicant.
Reference 1 Full Name
Reference 1 Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Reference 1 Relationship
Reference 1 Email Address
example@example.com
Reference 1 City
Reference 1 State
Reference 2 Email Address
example@example.com
Reference 2 City
Reference 2 State
Reference 2 Full Name
Reference 2 Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Reference 2 Relationship
Adverse History Questions
Have you ever declared bankruptcy?
Have you ever had a foreclosure?
Have you ever had a vehicle repossessed?
Are there any judgments against you?
Do you have any existing obligations not listed above?
Military / Veteran Status
Background Questions
Have you ever had a tax lien?
Tax lien explanation
Have you ever had past due child support?
Past due child support explanation
Do you have any current delinquent accounts?
Current delinquent accounts explanation
Bankruptcy explanation
Foreclosure explanation
Repossession explanation
Judgments explanation
Existing obligations explanation
Required Uploads
Driver's License (front and back) - Applicant

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Social Security Card - Applicant

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Last 4 Pay Stubs - Applicant

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Last 2 Years Tax Returns - Applicant

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Additional Income Documentation - Applicant

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Driver's License (front and back) - Co-Signer

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Social Security Card - Co-Signer

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Last 4 Pay Stubs - Co-Signer

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Last 2 Years Tax Returns - Co-Signer

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Additional Income Documentation - Co-Signer

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Authorizations & Consents
I authorize [Lender] to obtain credit reports and verify my employment and income as part of this application.
I consent to credit report and employment/income verification
I consent to obtain consumer credit report under FCRA.
I consent to obtain consumer credit report under FCRA
I consent to employment and income verification.
I consent to employment and income verification
I consent to receive electronic communications and disclosures.
I consent to receive electronic communications and disclosures
I certify that the information provided is true and correct to the best of my knowledge.
I certify that the information provided is true and correct to the best of my knowledge
I acknowledge that submitting an application does not guarantee approval.
I acknowledge that submitting an application does not guarantee approval
Electronic Signatures
Applicant Electronic Signature
Applicant Signature Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Co-Signer Electronic Signature
Co-Signer Signature Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Collateral or equipment details
Do you have a co-signer or co-applicant?
Co-Applicant Full Legal Name

First NameLast Name
Co-Signer Other Income (USD)
Co-Signer Bank Name
Co-Signer Bank Routing Number
Co-Signer Bank Account Number
Co-Signer: Have you ever declared bankruptcy?
Co-Signer: Have you ever had a foreclosure?
Co-Signer: Have you ever had a vehicle repossessed?
Co-Signer: Are there any judgments against you?
Co-Applicant Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Co-Applicant Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Co-Applicant Email Address
example@example.com
Co-Applicant Current Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Co-Applicant Housing Status
Co-Applicant Monthly Rent or Mortgage Payment (USD)
Co-Applicant Employer Name
Co-Applicant Job Title
Co-Applicant Length of Employment (years)
Co-Applicant Annual Income (USD)
Should be Empty:

Goolsby Financial Credit Application

Applicant Information

Residence History

Loan Request Details

Applicant Employment

Co-Signer Information

Consent and Authorization

Personal Information

Loan Request

Employment History

Banking and Financial Information

Assets and Liabilities

References

Adverse History Questions

Background Questions

Required Uploads

Authorizations & Consents

Electronic Signatures