HFLA EDUCATION LOAN APPLICATION - Hebrew Free Loan of Austin

APPLICANT PERSONAL INFORMATION

Student's Name*

First Last

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Is your legal address within the greater Austin area?*

Yes
No

Amount Requested*

(Up to $20,000 with 2 Guarantors)

School Attending

Tell us a bit about how far along you are in your educational journey and what is coming in the near future.

Indicate your relationship to the Jewish community.*

I am Jewish.
I am not Jewish, but I work for a Jewish communal agency.
I am not Jewish and have no connection to the Jewish Community.

If Other, please give details*

Specify anyone who referenced you to HFLA:

US Citizen or Legal Resident?

Yes
No

FAMILY INFORMATION

Applicant's Marital Status*

Spouses's Name*

First Last

Spouse's Email*

Do you have any dependents?*

Yes
No

GUARANTOR 1 INFORMATION

(1 Guarantor for each $10,000 requested)

Name of Guarantor 1*

First Last

Relationship to Guarantor 1*

cannot be self or spouse

Guarantor 1 Cell Phone Number*

Guarantor 1 Email*

Do you have more than 1 Guarantor?*

Yes
No

GUARANTOR 2 INFORMATION

(if applying for more than $10,000)

Name of Guarantor 2

First Last

Relationship to Guarantor 2

cannot be self or spouse

Guarantor2 Cell Phone Number

Guarantor 2 Email

EMERGENCY CONTACT

Your emergency contact will not be used for collections. This person(s) has your permission to discuss loan and payment details in the event of an emergency.

Emergency Contact 1*

First Last

Emergency Contact 2

First Last

BANKING & EQUITY

Bank Name*

Amount Held

Checking

Savings

Stocks, Mutual Funds or other investments excluding 401k

Estimated value of car(s)

Equity on property

APPLICANT EMPLOYMENT & INCOME

Applicant's Occupation*

Name of Employer*

Business Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Business Phone

Employed Since

Take-home Pay (after taxes) per month*

SPOUSE EMPLOYMENT & INCOME

(if applicable)

Spouse's Occupation

Name of Spouse's Employer

Take home pay (after taxes) per month

Employed since

TOTAL INCOME

Other Income (alimony, retirement pension, child support, etc)

Total Monthly Household Net Income*

MONTHLY EXPENSES

Rent/Mortgage*

Food*

Utilities*

Telephone, internet and cable*

Medical Insurance (if applicable)*

Car Insurance*

Car Payments (if applicable)*

How many months remaining on car payments?

Dependent(s) School Fees (daycare/preschool, private school, religious school)

Other Monthly Expenses (synogogue dues, entertainment, gas, subscriptions, school tuition, child support, etc)

Total Monthly Expenses*

MONTHLY NET=

Total Net Income MINUS Total Monthly Expenses

Monthly Net*

DEBT

*Please note all applicants are required to submit a free credit report.

Credit Card Balance(s)*

For each credit card, please list (1) name (2) balance and (3) how much you pay monthly.

Approximate Monthly Credit Card Payment*

Total Credit Card Debt*

Student Loans

Other Debt: Please list name of creditor, type of debt, amount, monthly payment and date last paid.*

(Mortgages, loans, credit cards, etc.)

Have you every filed for bankruptcy?

Yes
No

Required Supportive Documentation for Applicants

Please email to loans@hfla.org: Copy of your driver's license (or other valid picture ID), most recent employer paystub, most recent W2, free credit score (showing your name), 2 most recent months' bank statements

Please explain how you will have the monthly resources to make the loan payments to HFLA.*

The undersigned hereby certifies that the information provided is true, correct and complete. HFLA is authorized to make inquiries and gather information that it feels is necessary concerning statements made on this application. It is further agreed that HFLA will be promptly notified of any material changes in this information.

Applicant's Name*

First Last

Consent*

I agree

I agree to the terms of this application and loan

Today's Date*

Spouses Name

First Last

Spouse - I agree

I agree

I agree to the terms of this application and loan.

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EDUCATION LOAN APPLICATION

EDUCATION LOAN APPLICATION

APPLICANT PERSONAL INFORMATION

FAMILY INFORMATION

GUARANTOR 1 INFORMATION

GUARANTOR 2 INFORMATION

EMERGENCY CONTACT

BANKING & EQUITY

Amount Held

APPLICANT EMPLOYMENT & INCOME

SPOUSE EMPLOYMENT & INCOME

TOTAL INCOME

MONTHLY EXPENSES

MONTHLY NET=

DEBT

Required Supportive Documentation for Applicants

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