Loan Application for Gemstone Financial Order Number Car / Title / 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 Idaho Zip Code * NUMBER OF YEARS AT ADDRESS COST OF RENT OR MORTGAGE LAST 4 NUMBERS 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 TITLE 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 GEMSTONE 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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