US Military Loans, Inc.

Loan Application

All fields labeled in red are REQUIRED and must be completely filled out in order to submit the form. Please do not apply until you have reviewed all TERMS.

PURCHASE INFORMATION
Purchase Price:
Down Payment:
Auto Dealer Name:
Sales Person's Name:

AUTOMOBILE INFORMATION
Year:
Make:
Model:

PERSONAL INFORMATION
First Name:
Middle Initial:
Last Name:
SSN:	EX - 123456789
Date of Birth:	MM/DD/YYYY
Personal E-Mail Address:	Valid e-mail address required.
Military E-Mail Address:	Valid e-mail address required.
Home Phone:	EX - 1234567890
Cell Phone:	EX - 1234567890
Marital Status:	Married Divorced Separated Single
Number of Dependents:

UNIT AND MILITARY INFORMATION
Rank	(You must be at least an E2)
Branch of Service
Complete Name of Unit:	EX - HHB. Div Arty, 1st AD
Unit Number:
1st Sgt's Name:
CMR & Box Number:
Unit Phone #:
APO AE, AP, or FPO:
Years Active Duty:
Date Arrived in Germany:	MM/DD/YYYY
ETS Date:	MM/DD/YYYY (You must have at least 12 months left)
DEROS:	MM/DD/YYYY
Do you live in:	Quarters Barracks Rented/Economy

SPOUSE INFORMATION

First Name:

Middle Initial:

Last Name:

Social Security Number:

EX - 123456789

Date of Birth:

MM/DD/YYYY

Employment:

Employed Unemployed

Position/Rank:

<< Civilian Job Title Here

Employer's Name:

Name	Address	Telephone Number
STATESIDE REFERENCES (Friends/Relatives Other than HOR)
1.

2.

3.

EXISTING AUTOMOBILE LOAN
Existing Auto Loan?	Yes No
Year:
Make:
Model:
Monthly Payment:
Balance Owing:
Lien Holder:

Allotment Amount Deducted	Payable to Which Company or Individual	Remaining Balance
ALLOTMENT LOAN
Please identify from your LES every Discretionary and Bank allotment deduction below.
1.
2.
3.
4.
5.

COVERED BORROWER IDENTIFICATION STATEMENT
Federal law provides important protections to active duty members of the Armed Forces and their dependents. To ensure that these protections are provided to eligible applicants, we require you to indicate one of the following statements as applicable:
	I AM a regular or reserve member of the Army, Navy, Marine Corps, Air Force, or Coast Guard, serving on active duty under a call or order that does not specify a period of 30 days or fewer.
	I AM a dependent of a member of the Armed Forces on active duty as described above, because I am the member's spouse, the member's child under the age of eighteen years old, or I am an individual for whom the member provided more than one-half of my financial support for 180 days immediately preceding today's date.
	I AM NOT a regular or reserve member of the Army, Navy, Marine Corps, Air Force, or Coast Guard, serving on active duty under a call or order that does not specify a period of 30 days or fewer (or a dependent of such a member).

By submitting this electronic application to US Military Loans, Inc. I/we certify that I/we have reviewed this credit application and verify that all of the information contained in it to be correct to the best of my/our knowledge. I/We hereby authorize and instruct your Company to request and obtain credit information about me/us from any credit reporting agency or third party as well as to answer any future questions about your credit experience with me/us. I/We understand that you will retain this application for credit whether or not it is approved. I/We confirm there is no action pending that may lead to a potential discharge or disciplinary action.

IT MAY TAKE UP TO 30 SECONDS TO SUBMIT THE APPLICATION. PLEASE CLICK ONLY ONCE.