IMPORTANT APPLICANT INFORMATION:
Borrower Information
Name:*
Birth Date:*
First Name MI Last Name Suffix JR SR II III IV V VI VII VIII IX
Month Day Year
SSN:*
Re-enter SSN:*
Employer:*
ACTIVE DUTY GOVERNMENT RETIRED
Branch of Service:*
AIR FORCE ARMY COAST GUARD MARINES NAVY Only required for Active, Activated Reservist/Guard or Retired Military
Current location:*
Continental United States Alaska, Hawaii, or Puerto Rico Overseas
Country of Residence:*
US
Email Address:*
Marital Status:*
Married Single Divorced Widowed
Number of Dependents :
0 1 2 3 4 5 6
Borrower Address Information
Address:*
(EX. 101 Main/ USS Nimitz CVN 70)
Home Phone:*
(EX. Number)
(EX. apt a / E-div / Eng. Dept)
Cell Phone:
City:*
(EX. Las Vegas/FPO)
Housing Type:*
Barracks Housing Own Rent
State/Zip:*
AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY AA AE AP AS FM GU MH MP PR PW VI
Monthly Rent/Mortgage Payment:*
$ Amount is required if you Rent.
Military and Income Information
Command/Unit Name:*
Unit Phone:*
Supervisor Name:*
(E6 and above)
Supervisor Phone Number:*
Your Rank:*
E1 E2 E3 E4 E5 E6 E7 E8 E9 O1 O2 O3 O4 O5 O6 O7 O8 O9 W1 W2 W3 W4 W5 Retired
BAH Received:*
No BAH With Dependents Without Dependents
Time In Service:* Enter one of the following pieces of Information.
Pay Entry Base Date: Time in Service: years months Month Day Year
ETS Information:*
ETS Date: Indefinite ETS? Must be E6 or higher to have Indefinite ETS Month Day Year
Expense Information
Child Support/Alimony Paid: $ monthly
Advanced Pay being Repaid:
Other Expenses:
Have you ever filed bankruptcy?
Date of Action:
Customer Preferences
How much do you need? :
$500 - $1,000 $1,000 - $2,500 $2,500 - $5,000 $5,000 - $7,500 7,500 +
What do you want to buy? :
Furniture Electronics Computers Home Appliances Smartphones/Tablets Rims/Tires
I certify that everything I have stated in this application and on any attachments is correct. Military Loans of America may keep this application whether or not it is approved. By signing below, electronically, I authorize Military Loans of America and it's assignees to check my credit and employment history and to answer questions others may ask about my credit record with Military Loans of America and it's assignees. I understand that I must update credit information at Creditor's request if my financial condition changes. By providing my email address, I consent to receive electronic information such as notices of credit decisions, monthly billing statements and collection notices. I have read and understand the above terms and conditions.*
A click constitutes a signature