Quick Loan Application

NYDAN LENDING GROUP

Quick Loan Application

Borrower Information

First Name *

Last Name *

Phone *

Email *

Address *

City *

State *

Postal code *

Date of birth *

SS# *

Work History (2 years min.) *

Total Monthly Income

Loan Amount Requested

Loan Amount to Be Used For?

Anticipated Loan Repayment Period

Co-Borrower Information

Co-Borrower Full Name

Co-Borrower Full Address

Co-Borrower Phone Number

Co-Borrower Date of Birth

Co-Borrower SS#

Co-Borrower Employment History (2yr Min)

Co-Borrower Monthly Income

By signing below, I hereby authorize NYDAN LENDING GROUP to verify my past and present employment, earnings records, bank accounts, stock holdings, and any other asset balances needed to process my application. It is understood that a photocopy of this document shall also serve as an authorization to provide the information requested. The information obtained is only to be used in the processing of my Ioan application. Programs, rates and conditions are subject to change without notice. We do business in accordance with Federal Fair Lending Laws. Equal Housing Lender

Borrower Signature *

Clear

Borrower Date Signed *

Co-Borrower Signature

Clear

Co-Borrower Date Signed