#4140102 GreenSky Credit App

Page 1

GreenSky Loan Application Information 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.

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

Mobile Phone

Suite/Apt #

(Physical address required. No P.O. Boxes)

City*

Email Address

/

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*

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

Co-Applicant Name on ID

] Passport

[

] Tribal Card

(please check one)

[

] Tribal Card

(please check one)

ID Expiration Date

ID Number

] Passport

ID Expiration Date

ID Number

Sales Consultant

Name

Phone Number

Email Address

You may process the application at www.greenskycredit.com/consumer or fax to 480-287-8612.

Please see Disclosures continued on the next page - Page 1 of 2


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