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Applicant Information


Your Name (required)

Your Email (required)

Date of Birth (required)
SSN (required)
Phone (required)
Time at current residence (required)
Home address (incl. City, State, ZIP) (required)



Loan Information


Amount of loan requested (required)

Purpose for the Loan (required)



Income Information


Current Income Source (Employer, SSI, Disability, etc) (required)

Employer Address

City
State
ZIP
Phone Number (required)
How Long? (required)




Comment Section


Comments regarding application
(include any information that you think will benefit us in the approval process)



Loan Application Declaration


I authorize Bonaire Finance Company LLC to verify the information provided on this form as to my credit and employment history to include pulling a credit report.

Signature
Date

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The following documentation is required to review your application:

  • 1. State issued ID - must not be expired
  • 2. Proof of income for the past 30 days, i.e. paystubs and/or bank statements
  • 3. Proof of residency within the past 30 days, i.e. phone bill, utility bill, lease, all dated within the last 30 days
  • 4. Five references to include Name, Address, and phone number