1 Contact Info 2 First Section 3 Second Section 4 Third Section 5 Fourth Section 6 Privacy Policy How can we contact you? Let's start with a little information about you. First Name * Required Middle Name Required Last Name * Required Email Address * Required Confirm Email Address * Required Address Line 1 * Required Address Line 2 City * Required State * Required Please select a state Alabama Alaska American Samoa Arizona Arkansas California Colorado Connecticut District of Columbia Delaware Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Northern Mariana Islands Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington U.S. Virgin Islands West Virginia Wisconsin Wyoming Zip * Required Date of Birth *Invalid Date Social Security Number *Required Phone Number *Required First Section Please answer all the questions. Name of the business (if applicable): * Required Business Tax ID Number (if applicable): * Required Co-borrower name(s) (if applicable): * Required Co-borrower SSN (if applicable): * Required Primary phone number: * Required Co-signers' name(s) (if applicable): * Required Co-signers' address (if applicable): * Required Second Section Please answer all the questions. Amount of money requested: * Required $ Describe the purpose of the loan: * Required Desired monthly payment: * Required $ Desired loan term (in months): * Required Third Section Please answer all the questions. What are your places of employment/sources of income? * Required What is your total take-home pay? * Required $ What are your total monthly expenses? * Required $ Describe the primary collateral to secure this loan: * Required Estimate the value of the primary collateral: * Required $ Describe any additional collateral to secure this loan: * Required Estimate the value of the additional collateral: * Required $ Fourth Section Please answer all the questions. Estimate the value of cash on hand & in bank accounts: * Required $ Estimate the value of retirement accounts: * Required $ Estimate the value of real estate holdings: * Required $ Estimate the value of investment accounts: * Required $ Estimate the value of automobiles & personal property: * Required $ Estimate the value of any additional assets: * Required $ Estimate the amount of loans payable outstanding: * Required $ Estimate the total amount of credit card debt outstanding: * Required $ Estimate the principal mortgage balance outstanding: * Required $ Estimate the total amount of any other debts outstanding: * Required $ Privacy Policy Please read and accept the privacy policy to continue. Accept Privacy Policy You're done! Thank you for completing your application! You can now begin signing your closing documents. Thank you for completing your application!Your financial institution is reviewing your application and will contact you for the next steps.You can now safely close your browser window or tab. Thank you for your submission! Your financial institution will contact you for the next steps.You can now safely close your browser window or tab. © Copyright 2024 Epic River Financial, Inc. All rights reserved. Version 23.4.3.17