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Loan Application

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Loan Application (FOR WISCONSIN RESIDENTS ONLY)

You must be at least 18 years old to apply.

If you are not a Wisconsin resident your application will not be processed and your information will not be kept.

To complete the application process you must complete this application entirely. Items marked with a * are required in order to submit the application. IF YOU DO NOT FILL OUT THE APPLICATION COMPLETELY AND/OR IF YOU DO NOT SUPPLY THE REQUIRED DOCUMENTATION ENTIRELY, YOUR APPLICATION WILL NOT BE CONSIDERED!!!
If you require any assistance in completing the application process please call us at 1-888-773-3391 and enter extension 1076.
There are several items you may wish to prepare and have ready ahead of time. SpeedyLoan will require the following supporting documents to be submitted by attaching them digitally to this application or faxing or e-mailing them to us.
Proof of your identity - your driver's license or state-issued ID, plus one other form of ID.
Proof of your residence - A recent utility bill or a piece of mail with the postal cancellation date and name and address visible
Proof of your income - Your most recent pay stub, SS award letter, or retirement income documentation.
A complete copy of your most recent checking account statement, showing at least 30 days of activity.
A copy of a voided check from that same account.
Copies of any other documentation that you wish to provide.
If you will fax the documents legible paper copies will work fine. If you wish to email or attach documents to this on-line application, you will need to have digital versions of these documents available in one or more of the following file formats; (PDF, BMP, GIF, JPEG, JPG, PNG, PSD, TIFF, DOC, DOCX). Note - You can attach some and fax some, as each is done separately. This Application is very easy to use and will allow you to select the files to attach at the appropriate times throughout the process. The fax number and email address will be provided for you along with a list of documents to send at the end of the application.
WARNING - IT IS IMPORTANT TO FILL OUT THIS APPLICATION ACCURATELY. KNOWINGLY MAKING FALSE STATEMENTS ON A CREDIT APPLICATION IS A CRIME.

First Name
*

Last Name
*

Social Security Number
*

Email Address
*

Primary Phone Number
*

Where can we contact you?

Primary Phone Type

Alternate Phone Number

Where can we reach you if you aren't available at your primary phone number?

Street Address
*

Street Address

Please enter the address where you live and receive your mail. If these are not the same, enter an additional address below.

Street Address

City

State (You must be a Wisconsin resident - If you are not please do NOT complete this application.

Zip/Postal

Years at address
*

How many years have you lived at the address above?

Additional address

Only fill out this field if the address you live at and the address you receive mail at are different.

Additional address

City

State/Province

Zip/Postal

Initials for approval
*

By my initials, I grant SpeedyLoan permission to contact me via e-mail, text, and/or telephone regarding any issues or questions related to my account.

Initials for approval
*

By my initials, I grant SpeedyLoan permission to contact the references and/or personal contacts that I include in this application or supply via alternate means, regarding any issues or questions related to my application and/or transaction(s) with SpeedyLoan.

How will you provide proof that this is your current address?
*

Upload Proof of Address

Drop a file here or click to upload
Choose File

Maximum upload size: 8MB

Driver's License or State ID#
*

State
*

Date of Birth
*

What secondary form of ID will you submit?
*

What secondary form of ID will you submit?

How will you submit copies of these IDs?

Upload ID files here

Drop a file here or click to upload
Choose File

Maximum upload size: 8MB