TMIKY - IDT - Choice MD Loan Application

CAMPUS INFORMATION:

Admission Representative:  

Applicant Information

First Name: Middle Initial:   Last Name:  

SSN: Phone #: Date of Birth:

Street Address:  

City:   State:   Zip Code:  

Time at Address - Years:   Months:   Rents/Mortgage: $   Type:  

Email Address: Are you a US Citizen?  

License/ID Information

Photo ID#: Issuance State:   Exp. Date:

Has your license ever been revoked?  

Employment Information

Current Employer:   Position:  

Time Employed -  Years: Months: Hourly Rate: $ Weekly Hours:  

Employer Phone Number:  

Previous Employer if current position is less than 6 months:

Current Employer:   Position:  

Time Employed -  Years: Months:   Hourly Rate: $   Weekly Hours:  

Employer Phone Number:  

Other Income Sources

Spouse: $ Child Support: $ Other: $  

Bank Information

Bank Name: Routing #: Account #: 

Uploaded Image of Voided Check:

Cosigner Information

First Name: Middle Initial: Last Name:  

SSN: Phone #: Relation: DOB:

Street Address:  

City: State: Zip Code:  

E-Mail Address:  

Time at Address - Years:   Months:   Rents/Mortgage: $   Type:  

Cosigner Employer Information

Current Employer:   Position:  

Time Employed -  Years: Months: Hourly Rate: $ Weekly Hours:  

Employer Phone Number:  

Terms & Conditions of this Loan Application

Notice: You represent that all of the information you provided to TMIKY, IDT, or Choice MD in your Application is true and correct to the best of your knowledge, and may be relied upon by us. By completing the pre-qualification Loan application form you are giving TMIKY, IDT and Choice MD written authorization to access your credit profile for pre-qualification purposes. I understand that TMIKY, IDT or Choice MD will be acting as a loan-processing agent on my behalf and therefore does not set the rate and terms of my loan, approve or deny, discriminate against anyone for any reason or guarantee my loan approval. I understand that there may be additional fees and discounts associated with my loan approval and that I may be charged a loan processing fee if I elect to accept the terms of my loan. Furthermore, while calculated monthly, I understand that the total amount of the fees will be added to my base loan amount requested and become a part of my principal balance. I understand that TMIKY is obligated to explain these fees to me before I sign additional loan documents. I agree to "hold harmless" TMIKY from any and all legal actions that might be takes as a result of a disputed mater with my Service Provider or Vendor.

Merchant/Vendor: 1TopSchool - 2720 Old Rosebud Road, Suite 230 - Lexington, KY 40509 859.368.0575

 

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Signature Certificate
Document name: Loan Application
lock iconUnique Document ID: b0b83f2926187026dce9b84806545542f03ed32e
Timestamp Audit
August 19, 2022 1:31 pm GMTLoan Application Uploaded by Greg Goins - [email protected] IP 99.190.9.234
August 19, 2022 1:32 pm GMTLoan Application - [email protected] added by Greg Goins - [email protected] as a CC'd Recipient Ip: 99.190.9.234
August 30, 2022 5:08 pm GMTLoan Application - [email protected] added by Greg Goins - [email protected] as a CC'd Recipient Ip: 99.190.9.234
August 30, 2022 5:08 pm GMTLoan Application - [email protected] added by Greg Goins - [email protected] as a CC'd Recipient Ip: 99.190.9.234
September 19, 2022 12:49 pm GMTLoan Application - [email protected] added by Greg Goins - [email protected] as a CC'd Recipient Ip: 99.190.9.234