Loan Application for Peak Financial Name YOU MUST READ AND AGREE TO THE TERMS OF THIS LOAN FEE SCHEDULE BEFORE YOU WILL BE ALLOWED TO SUBMIT A LOAN APPLICATION EXAMPLES OF TOTAL COSTS: Cash advance $1,000.00 Amount Financed $1,000.00 Payable in 12 monthly installments of $100.46 per month Finance charge $205.52 Total of payments $1,205.52, APR 36.00% Cash advance $10,000.00 Title registration fee $8.00 Amount financed $10,008.00 Payable in 36 monthly installments of $377.05 per month Finance charge $3,565.80 Total of payments $13,573.80, APR 21.00%. DEFERRAL CHARGE: The Lender may, at any time, grant a deferral postponing the scheduled due date of the earliest unpaid installment and all subsequent installments as originally scheduled or as previously deferred for a period of time determined by the Lender in exchange for a deferral charge. The deferral charge is computed in accordance with Section 3 2-5-301(3)(a),(b), and(c), MCA. LATE CHARGE: If any payment is more than 10 days past due, a late charge of 5 cents may be collected on each $1.00 or part of $1.00 of the unpaid amount of the payment, or $15.00 whichever is greater. No late charge shall exceed $50.00. ATTORNEY FEES: You agree to pay reasonable attorney fees and court costs arising from the collection or enforcement of this Combination Note, Security Agreement, and Federal Disclosure Statement, provided Lender receives a favorable final judgment. DISHONORED CHECK FEE: In the event any check, draft or instrument I give Lender as a full or partial payment under this agreement is dishonored, returned to Lender as an insufficient funds instrument or dishonored for any other reason, I will pay to Lender a fee of $25.00. I have read, understand, and accept these terms. * Yes No, I do not accept these terms Car / Consolidation / Personal Loan Application To apply for a loan, please fill out this application. We will call you and ask you more questions about your finances. We also pull a credit report and verify employment. APPLICANT INFORMATION FIRST NAME * LAST NAME * ADDRESS STREET 1 * ADDRESS STREET 2 CITY STATE Montana Zip Code * NUMBER OF YEARS AT ADDRESS COST OF RENT OR MORTGAGE LAST 4 OF SOCIAL SECURITY NUMBER * EMAIL ADDRESS * DATE OF BIRTH * DAYTIME PHONE * EVENING PHONE JOB INFORMATION EMPLOYER * EMPLOYER STREET ADDRESS EMPLOYER CITY EMPLOYER STATE - Select Province/State - Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Nova Scotia Northwest Territories Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon ==================== Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming EMPLOYER PHONE POSITION HELD MONTHLY NET AMOUNT * TIME AT EMPLOYMENT LOAN REQUEST INFORMATION LOAN TYPE REQUESTED * AUTO LOAN CONSOLIDATION LOAN PERSONAL LOAN LOAN AMOUNT REQUESTED * PROPERTY/COLLATERAL INFORMATION MAKE OF VEHICLE MODEL OF VEHICLE YEAR OF VEHICLE MILEAGE OF VEHICLE VIN NUMBER COMMENTS I AUTHORIZE PEAK FINANCIAL LOANS TO VERIFY MY CREDIT AND EMPLOYMENT HISTORY YES, I AUTHORIZE THESE CHECKS NO, I DO NOT AUTHORIZE CHECKS, CANCEL
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