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GreenSky Loan Application Information
By submitting this Loan Application, you agree that you are applying for any product any financial institution participating in the GreenSky loan program (each “Lender”) may offer as part of the
GreenSky loan program regardless of any product your Contractor may have specifically discussed with you.
Applicant Information
Requested Loan Amount (if known):
First Name*
Middle Initial
Last Name*
Date of Birth (mm/dd/yyyy)
/
Social Security Number*
Applicant Street Address*
Home Phone
Mobile Phone
Suite/Apt #
(Physical address required. No P.O. Boxes)
City*
State*
Email Address
/
Zip Code*
(If you provide an email address, GreenSky may use it to contact you about GreenSky products, services, special offers and other promotions)
Employer*
Years on the Job*
Employer Phone Number*
If Applicant is retired, enter “Retired” in the Employer field, enter “0” in the Years on Job field and enter the Applicant’s home phone number.
If Applicant is unemployed, enter “Unemployed” in the Employer field, enter “0” in the Years on Job field and enter the Applicant’s home phone number.
Income
Alimony, child support or separate maintenance payments need not be revealed if you do not wish to have them considered as a basis for repaying the loan. Married Wisconsin Residents: Combine you and your spouse’s information once.
Applicant’s Gross MONTHLY Income ($)*
Other Gross MONTHLY Income ($)
Examples: monthly salary (before taxes) alimony,
child support, investment income, social security, etc.
Examples: Co-Applicant and/or spousal income (before taxes),
alimony, child support, investment income, social security, etc.
Co-Applicant Information
If completed below, Applicant and Co-Applicant intend to apply for joint credit.
First Name*
Middle Initial
Last Name*
Date of Birth (mm/dd/yyyy)
/
Social Security Number*
Co-Applicant Street Address*
Home Phone
(Physical address required. No P.O. Boxes)
City*
Email Address
/
Mobile Phone
Suite/Apt #
State*
Zip Code*
(If you provide an email address, GreenSky may use it to contact you about GreenSky products, services, special offers and other promotions)
Employer*
Years on the Job*
Employer Phone Number*
If Co-Applicant is retired, enter “Retired” in the Employer field, enter “0” in the Years on Job field and use the Co-Applicant’s home phone number.
If Co-Applicant is unemployed, enter “Unemployed” in the Employer field, enter “0” in the Years on Job field and use the Co-Applicant’s home phone number.
Applicant Signature
X
Applicant’s Signature
Please provide a government issued
picture ID to the Associate/Contractor.
Date
Co-Applicant Signature
X
If signed, Applicant and Co-Applicant intend to apply for joint credit.
Co-Applicant’s Signature
Please provide a government issued
picture ID to the Associate/Contractor.
Date
TO BE COMPLETED BY SALES CONSULTANT/ASSOCIATE
Plan Number
Dealer Number
Applicant Type of ID
[ ] Driver’s License
[ ] State/Province Issued ID
[ ] Military ID
[ ] Driver’s License
[ ] State/Province Issued ID
[ ] Military ID
Applicant Name on ID
Co-Applicant Type of ID
[ ] Passport
State of Issuance
Co-Applicant Name on ID
[ ] Tribal Card
(please check one)
ID Expiration Date
ID Number
[ ] Passport
State of Issuance
[ ] Tribal Card
ID Number
(please check one)
ID Expiration Date
Sales Consultant
Phone Number
Name
Email Address
You may process the application at www.greenskycredit.com/consumer or fax to 480-287-8612.
* Indicates that the field information must be included
Effective May 1, 2014
Please see Disclosures continued on the next page - Page 1 of 2
Continued from last page - Page 2 of 2
Married Wisconsin Residents
Applicant: Spouse’s First Name
Applicant: Spouse’s Street Address*
Middle Initial
(Physical address required. No P.O. Boxes)
City*
Co-Applicant: Spouse’s First Name
Co-Applicant: Spouse’s Street Address*
City*
Applicant: Spouse’s Last Name*
Suite/Apt #
State*
Middle Initial
(Physical address required. No P.O. Boxes)
Zip Code*
Co-Applicant: Spouse’s Last Name
Suite/Apt #
State*
Zip Code*
Disclosures
IMPORTANT INFORMATION ABOUT PROCEDURES FOR OPENING A NEW ACCOUNT: To help the government fight the funding of terrorism and money laundering activities, federal law requires all
financial institutions to obtain, verify and record information that identifies each person who opens a new account. What this means for you: When you open an account, we will ask for your name,
address, date of birth, and other information that will allow us to identify you. We may also ask to see your driver’s license or other identifying documents.
NOTICES: California Residents: If you are married, you may apply for a separate account. Ohio Residents: The Ohio laws against discrimination require that all creditors make credit equally available to all
credit worthy customers, and that credit reporting agencies maintain separate credit histories on each individual upon request. The Ohio civil rights commission administers compliance with this law.
Vermont Residents: We are engaged in loan production. Married Wisconsin Residents: If you are applying for individual credit or joint credit with someone other than your spouse, and your spouse also
lives in Wisconsin, combine your financial information with your spouse’s financial information. No provision of any marital property agreement, unilateral statement under Section 766.59 of the
Wisconsin statutes or court order under Section 766.70 adversely affects the interest of the lender, unless the lender, prior to the time credit is granted is furnished a copy of the agreement, statement or
decree or has actual knowledge of the adverse provision when the obligation to the lender is incurred. If married, you understand that your lender must inform your spouse if a credit account is opened
for you.
By submitting your request for credit each of you certify that (i) all of the statements made in this Application Information form or verbally communicated to your Contractor or your Contractor’s
Associates are true and correct and are made for the purposes of obtaining credit and (ii) if more than 1 Applicant, none is a co-signer (a “co-signer” is a person who agrees to be liable for the debt of
another person without receiving the benefit of the loan, whereas a “joint applicant” is a person who intends to apply for joint credit and will receive the benefit of the loan – although we allow joint
applicants to apply for joint credit, we do not allow borrowers to use “co-signers”). Further, you authorize us to: (1) obtain a credit report on you for any legal purpose in connection with this loan
application, including any update, extension of credit, review or collection of your loan, and (2) notify your Contractor or your Contractor’s Associates of our credit decision and (if approved) the proposed
loan repayment period. If you request, you will be informed whether any credit report was requested, and if so, the name and address of the consumer reporting agency furnishing this report. You agree
to provide additional financial information upon request. By submitting this loan application, you expressly authorize the shared disclosure of loan-related information, including, but not limited to, your
credit decision, proposed loan terms and personal credit scores, to any co-applicant, which will have the same effect as personal delivery to you.
By providing your mobile number, you authorize us to contact you at that number using automatic telephone dialing systems or artificial or prerecorded voices for any purpose, including, but not limited
to, to provide you with advertisements or telemarketing messages. You are not required to provide this consent as a condition of this loan application and may revoke your consent at any time by
contacting us at 1797 Northeast Expressway NE, Suite 100 | Atlanta, GA 30329
Upon loan approval, a Shopping Pass will be issued. Use of that Pass, or your Installment Loan, to make a purchase, whether in store, online, by telephone, through In-Home Services or otherwise, by (any)
Borrower (or any authorized user), will constitute acceptance of the Installment Loan Agreement governing the Pass by (all) Borrower(s). The physical and electronic records of any such purchase will
constitute the signature of (all) Borrower(s) on the Installment Loan Agreement. For any additional information or assistance, please contact Customer Service at 866-936-0602.
Online: www.greenskycredit.com • Email: [email protected] • Phone: 866-936-0602 • Fax: 480-287-8612
Effective May 1, 2014