IMPORTANT APPLICANT INFORMATION:

Federal law requires financial institutions to obtain sufficient information to verify your identity. You may be asked several questions and to provide one or more forms of identification to fulfill this requirement. In some instances we may use outside sources to confirm the information. By submitting this application for credit Exchange USA will obtain your credit bureau for review. The information you provide is protected by our privacy policy and federal law.
Fields marked with a * are required.

Borrower Information

Name:*

Birth Date:*

First Name       MI      Last Name           Suffix

Month    Day      Year

SSN:*

Re-enter SSN:*

Employer:*

Branch of Service:*


Only required for Active, Activated Reservist/Guard or Retired Military

Current location:*

Country of Residence:*

Email Address:*

Marital Status:*

Number of Dependents :

Borrower Address Information

Address:*


(EX. 101 Main/ USS Nimitz CVN 70)

Home Phone:*


(EX. Number)


(EX. apt a / E-div / Eng. Dept)

Cell Phone:


(EX. Number)

City:*


(EX. Las Vegas/FPO)

Housing Type:*

State/Zip:*

Monthly Rent/Mortgage Payment:*

$
Amount is required if you Rent.

Military and Income Information

Command/Unit Name:*

Unit Phone:*


(EX. Number)

Supervisor Name:*


(E6 and above)

Supervisor Phone Number:*


(EX. Number)

Your Rank:*

BAH Received:*

Time In Service:* Enter one of the following pieces of Information.

Pay Entry Base Date: Time in Service: years months
                                   Month     Day       Year

Time in Reserves:                                                    Break in Service:
Check this box if you have reserve time. Check this box if you have a break in service.

ETS Information:*

ETS Date:                    Indefinite ETS? Must be E6 or higher to have Indefinite ETS
                 Month     Day       Year


Customer Preferences

HOW DID YOU HEAR ABOUT US?:*

What do you want to buy? :

I certify that everything I have stated in this application and on any attachments is correct. Exchange USA may keep this application whether or not it is approved. By signing below, electronically, I authorize Exchange USA and it's assignees to check my credit and employment history and to answer questions others may ask about my credit record with Exchange USA and it's assignees. I understand that I must update credit information at Creditor's request if my financial condition changes. By providing my email address, I consent to receive electronic information such as notices of credit decisions, monthly billing statements and collection notices.

I have read and understand the above terms and conditions.*

 

A click constitutes a signature