Hebrew Free Loan Association of Greater Washington

Your Name

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First Name

Last Name

Social Security Number

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Please provide your full SSN

Date of Birth

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(mm/dd/yyyy)

Are you or your spouse Jewish?

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Are you a Federal Employee?

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We are sorry, based on your answers, you do not qualify for a loan. Please do not continue this application.

Please visit www.hebrewfreeloandc.org/faq for more information.

We are sorry, based on your answers, you do not qualify for a loan. Please do not continue this application.

Please visit www.hebrewfreeloandc.org/faq for more information.

Are you a US Citizen or Permanent Resident?

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Do you live in the DC metro area?

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Yes

No

We are sorry, based on your answers, you do not qualify for a loan. Please do not continue this application.

Please visit www.hebrewfreeloandc.org/faq for more information.

Are you married?

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Yes

No

Separated

Divorced

Spouse Name

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First Name

Last Name

Spouse Social Security Number - last 4 digits

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Please provide the last 4 digits of your spouse's SSN

Number of Dependent Children

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Ages of Dependent Children

Loan Information

Loan Amount Requested

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Maximum amount for emergency loans if $1,500

I understand that I am responsible to repay this loan in full within 2 weeks of recieving back pay. If I do not recieve back pay, I will need to show proof of such and will be given a repayment schedule.

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Yes

No

How did you hear about us?

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Friend/Family

Rabbi or synagogue communication

Facebook

Google/internet search

Partner organization or other non-profit referral

HFL newsletter

Other

Please provide any details on how your heard about us. For example, if you selected Facebook, please tell us what Facebook page or if you selected Rabbi, please tell us what Rabbi.

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We are gathering this information to best understand where our borrowers are getting their information so we can better market our loans in the future.

I hereby certify that the information provided is true, correct, and complete.

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I authorize the Hebrew Free Loan Association of Greater Washington (HFL) to investigate my credit, credential and/or employment history and authorize HFL to make inquiries and gather information that it believes is necessary concerning statements made on this application. I further agree to promptly notify HFL of any material changes in the information in this application.

Contact Information

Email

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Verify Email

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Spouse's Email

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Verify Email

*

Address

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Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Country

How long have you lived at this address?

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Do you own or rent this property?

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Own

Rent

Other

Cell Phone

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Spouse's Cell Phone

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Work Phone

Home Phone

Employment History

Occupation

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Federal Agency

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Spouse occupation

Spouse Employer

Pay Stubs

*

Please upload your two most recent pay stubs.

Additional Pay Stubs

If your pay stubs are in two separate files, please upload the second one here.

Notice of payment delay

*

Please upload your notification that you will not be receiving your pay.

Comments or Questions?

Notice to Borrower

Thank you for your interest in a loan from Hebrew Free Loan Association of Greater Washington (HFL). Please read the following statement and provide your electronic signature to signify that you agree. Please ask for an explanation if there is anything you don't understand.

I understand that I will be responsible to repay this loan as set forth in the Promissory Note. Loan repayment will be due within two weeks of the shut down ending.
I undetand that in the event that I default on the Promissory Note and fail to pay as agreed, The Hebrew Free Loan Association of Greater Washington can use any and all legal collection methods against me including but not limited to bringing a lawsuit against me in order to seek repayment of all monies due and owing, to get a judgment against me for the balance due and owing and engage in any post judgment proceedings to enforce any judgment entered against me, including the garnishment of wager where applicable.
I understand that if a judgment is entered against me that becomes a public record.
I understand that this application is not the contract that makes me liable for the debt.

I have read the Notice to Borrower and understand the responsibilities

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Yes

No