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Loan Amount

Basic Information

First Name*

Last Name*

SSN*

Email*

License Number*

Date of Birth*

License State*

Please check the box if you are active military or a dependent of active military.

Address Information

Address*

State*

City*

Zip Code*

Rent Or Own*

Months At Residence*

Home Phone*

Cell Phone*

Banking Information

Bank Name

Bank Routing Number

Bank Account Number

Bank Account Type

Income & Employment

Employment Type

Monthly Income

Employer Name

Work Phone*

Pay Frequency

Next Pay Date

Second Pay Date

Direct Deposit

Months at Job*

Agreements

I have read and I agree with the Privacy Policy, Terms & Conditions, & Mobile Communications Policy. I expressly consent to Blue Oak Credit contacting me at i) any telephone number, ii)any physical or home address iii) at any email address provided in this document, updated by me or provided by my references in the future, or ascertained by Blue Oak Credit through its resources.

By checking this box and clicking 'SUBMIT APPLICATION' below, I am providing my e-signature and giving my prior express written consent for Blue Oak Credit to deliver or cause to be delivered to me advertisements or telemarketing calls or texts using an automatic telephone dialing system or an artificial or prerecorded voice at the phone number provided above from or on behalf of Blue Oak Credit regarding Blue Oak Credit's products or services, even if my phone number appears on a state or federal do not call list. I understand this consent is not required as a condition of purchasing any property, goods or services. I may opt out at any time by calling 1-800-568-8577 or texting STOP to any message I receive. Message and data rates may apply.

I understand that upon submitting my application, Blue Oak Credit will review my information to determine whether I meet applicable lending criteria. I acknowledge that, by completing and submitting a loan application, I am applying for a loan. I understand that Blue Oak Credit verifies loan applicant information through credit reporting agencies, such as but not limited to, TransUnion, Equifax, or Experian and that Blue Oak Credit may obtain my credit information in order to determine my eligibility and ability to repay.