HFLA GROWING FAMILY LOAN APPLICATION - Hebrew Free Loan of Austin

APPLICANT PERSONAL INFORMATION

Name*

First Last

Address*

Street Address Address Line 2 City State ZIP Code

US Citizen or Legal Resident?*

Yes
No

Indicate your relationship to the Jewish community.*

I am Jewish.
I am part of a Jewish household. (i.e. Jewish partner)
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 (person or organization) who referred you to HFLA:

FAMILY INFORMATION

Applicant's Marital Status*

Spouse's Name*

First Last

Spouse's Email*

LOAN INFORMATION

Have you received an interest-free loan before?*

I am a first-time HFLA Applicant.
I am currently paying towards an HFLA loan.
I have paid off a previous loan from HFLA.
I have received a loan from another Hebrew Free Loan agency.
I have guaranteed a loan but not applied for one myself.

Amount Requested*

(Up to $10,000 with Guarantor)

General Purpose of Loan (i.e. debt, medical, home repairs, etc.)*

More specifically, how will you use the loan money?*

GUARANTOR* INFORMATION

(*To qualify for a loan greater than $1,000, Guarantor must be someone different from Borrower. See FAQ for more information.)

Name of Guarantor*

First Last

Relationship to Guarantor*

cannot be self or spouse

Guarantor Cell Phone Number*

Guarantor's 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*

Amounts 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 Take-home Pay (after taxes) per month

Employed since

TOTAL INCOME

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

$ Total OTHER INCOME from Above*

(enter 0 if not applicable)

Total Monthly Household Net Income

take-home pay + other income

MONTHLY EXPENSES

How many months remaining on car payments?

Other Monthly Expenses (synagogue dues, entertainment, subscriptions, school tuition, etc.)

$ Total OTHER EXPENSES from Above*

(enter 0 if not applicable)

Dependent(s) Care Expenses (daycare/preschool, private school, religious school, after care, child support)

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.

Total Credit Card Debt*

Approximate Monthly Credit Card Payment*

Student Loans

Other Debt: Please list name of creditor, type of debt, amount, monthly payment and date last paid. (i.e. line of credit, personal loan)*

Have you every filed for bankruptcy?*

Yes
No

Required Supportive Documentation for Applicants

1. Copy of your driver's license (or other valid picture ID) 2. Most recent employer pay stub 3. Most recent W-2 4. Free Credit Score (showing your name) 5. 2 most recent months' bank statements

Upload as many of the following documents of support that you have available.

Please email all remaining documents to loans@hfla.org as soon as possible.

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 to the terms of this application and loan.

Today's Date*

GROWING FAMILY LOAN APPLICATION

GROWING FAMILY LOAN APPLICATION

APPLICANT PERSONAL INFORMATION

FAMILY INFORMATION

LOAN INFORMATION

GUARANTOR* INFORMATION

EMERGENCY CONTACT

BANKING & EQUITY

Amounts Held

APPLICANT EMPLOYMENT & INCOME

SPOUSE EMPLOYMENT & INCOME

TOTAL INCOME

MONTHLY EXPENSES

MONTHLY NET=

DEBT

Required Supportive Documentation for Applicants

Upload as many of the following documents of support that you have available.

CONTACT US