Step 1 of 4

Personal Information

Please fill out all required fields below. You must be at least 18 years of age to be eligible for a loan.
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* Required Fields

First Name *

Last Name *

Email *

Confirm Email *

Cell Phone Number *

Home Phone Number *

Date of Birth *

Loan Amount *

Are you serving on active military, national guard, or reserve duty as a member of the armed forces, or are you a spouse, child or dependent of such a member? *

Yes, I am

No, I am not

Driver License State *

Driver License ID # *

Social Security Number *

Confirm Social Security Number *

Street Address 1 *

Apt / Suite #

City *

State *

Zip *

Occupant Status *

Time at Current Address *

Step 2 of 4

Employment Information

Please fill out all required fields below.
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* Required Fields

Employment Status *

Employer Name *

Work Phone Number *

Occupation

Time at Job *

How often are you paid? *

Payroll Method *

Next Pay Date *

Gross Monthly Income *

Step 3 of 4

Banking Information

Please fill out all required fields below.
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* Required Fields

Bank Routing Number *

Bank Name *

Bank Account Number *

Confirm Bank Account Number *

Bank Account Type *

How long has your bank account been open? *

Step 4 of 4

Disclosures

Once you agree to the following disclosures, your application will be sent off for review!

Disclosure Statement

Federal E-Sign Act Disclosure and Consent and Consent to Auto-dialed Marketing Calls and Text Messages:

By checking the "I AGREE" box, you consent to receive the disclosure immediately below electronically. You may withdraw your consent by unchecking the "I AGREE" button before continuing, but understand that doing so means that we will not be able to contact you as described below. To update your contact information or obtain a copy of the disclosure, you may call us at (800) 773-6127, or email us at customerservice@riverstonelending.com. You understand that you need a computer with Internet access and a compatible browser to view, print or save this disclosure.

Consent to Auto-dialed Marketing Calls and Text Messages. By checking the "I AGREE" box, you authorize Riverstone Lending. (or its agents), to make telemarketing calls and send marketing text messages to your telephone number listed above using an automatic telephone dialing system on a recurring basis. Signing this consent is not a condition of purchasing property, goods or services through us. If you do not wish to receive sales or marketing calls or texts from us, you should not check the "I AGREE" box. You understand that any messages we leave for you may be accessed by anyone with access to your voicemail or texts. You understand that your mobile phone service provider may charge you fees for calls made or texts sent to you, and you agree that we will have no liability for the cost of any such calls or texts. At any time, you may withdraw your consent to receive marketing calls and text messages by calling us at (800) 773-6127, emailing us at customerservice@riverstonelending.com., or by other reasonable means. Alternatively, to stop marketing text messages, simply reply "STOP" to any marketing text message that we send you.

BY CHECKING THE "I AGREE" BOX AND PROVIDING YOUR TELEPHONE NUMBER, , (1) YOU CONSENT TO OUR PROVIDING AUTODIALED MARKETING CALLS AND TEXTS PER THE DISCLOSURE (ABOVE) TO YOU ELECTRONICALLY, (2) YOU CONSENT TO OUR MAKING TELEMARKETING CALLS AND SENDING MARKETING TEXT MESSAGES TO YOUR TELEPHONE NUMBER AND (3) YOU ACKNOWLEDGE THAT YOU PRINTED OR SAVED A COPY OF THIS AGREEMENT.

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I have read, understood and agree to the terms of the Federal E-sign Act Disclosure and Consent, and thereby agree to receive all disclosures and notices in electronic form. I further certify that the information I have provided above is accurate and true and that I have read and understood the terms and conditions.

I have read, understand and agree to the terms of the Consent to Auto-dialed Marketing Calls and Text Messages.

I agree and acknowledge that by completing and submitting this website application that I am applying for a Loan. Riverstone Lending must verify applicant information through national databases including, but not limited to, Clarity and Data X and we may pull your credit in order to determine your eligibility and ability to repay.

Covered Borrower Statement: Federal law provides important protections to members of the Armed Forces and their dependents relating to extensions of consumer credit. In general, the cost of consumer credit to a member of the Armed Forces and his or her dependent may not exceed an annual percentage rate of 36 percent. This rate must include, as applicable to the credit transaction or account: the costs associated with credit insurance premiums; fees for ancillary products sold in connection with the credit transaction; any application fee charged (other than certain application fees for specified credit transaction or accounts); and any participation fee charged (other than certain participation fees for a credit card account).

The Military Lending Act (MLA) requires some disclosure be provided to you orally. If you would like to hear the oral disclosure, please call 1.888.593.3278.

You represent and warrant that YOU ARE NOT a member of the armed forces serving on active duty or active National Guard and Reserve duty or a dependent of a member of the armed services. You understand that, if approved, we will be making this loan in reliance on the truth of this statement.

I certify the information given in connection with this loan application to be true and accurate to the best of my knowledge, and I give Riverstone Lending consent to obtain information about me from a consumer reporting agency or other sources as detailed in the disclosures.

(Not required)