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PERSONAL LOAN APPLICATION - PDF

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                                                                                                                                                                          CitiFinancial, Inc.
PERSONAL LOAN APPLICATION                                                                                                                                                 300 St. Paul
PLEASE COMPLETE THE ENTIRE APPLICATION IN BLUE OR BLACK INK.                                                                                                              Baltimore MD, 21202
PLEASE RETAIN A COPY OF THE COMPLETED APPLICATION FOR YOUR RECORDS.


1. Tell Us About Yourself


First Name                                           MI             Last Name                                                     Social Security Number                             -            -

Home Phone Number                                                         Cell Phone                                               Date of Birth                  /          /                        (mm / dd / yyyy)
       At least one phone number must be entered.


What is the best time to contact you?                                  am.       /pm.                                 Time Zone          EST        CST           MST       PST             HST



Street Address                                                                            Apt./Unit Number


City                                                    State                     Zip Code                            Is this your mailing address?                Yes      No



How long at your current address?                      Years               Months

  Previous Home Address 1                                                                                      Previous Home Address 2


  Street Address                                                                                               Street Address


  Apt./Unit Number                                                                                             Apt./Unit Number


  City                                          State                    Zip Code                              City                                           State                      Zip Code


  How long at this address?                  Years              Months                                         How long at this address?                  Years             Months



2. Tell Us About Your Work and Finances

                                                                                                                                Date Hired
Employer Name                                                  Job Title/Position                                               Date Retired                          /          /                      (mm / dd / yyyy)
                                                                                                                                      Please check the appropriate box.


Work Phone                                       Work Extension                                               Gross Salary / Pension                                      Annual            Monthly


Other Income                                    Annual          Monthly
        If unemployed, you can enter your other income here. Alimony, child support, or separate maintenance income need not be revealed if the
        applicant does not wish to have it considered as a basis for determining credit worthiness, including applicant's ability to repay this obligation.

  Previous Employer 1                                                                                          Previous Employer 2


  Employer Name                                                                                                Employer Name


  Job Title/Position                                                                                           Job Title/Position


  Date Hired                   /            /                    (mm / dd / yyyy)                              Date Hired                   /            /                  (mm / dd / yyyy)




Do you currently rent or own your home?                         Rent         Own                         What is the monthly rent or mortgage?


Do you have additional expenses?                     Yes         No                       What is the monthly amount of the additional expenses?
                                                                                                     If you have additional expenses enter your monthly amount here. If you do not have any additional
                                                                                                     monthly expenses skip this question and proceed to the next line.

3. Tell Us About Your Co-borrower (optional)


First Name                                           MI             Last Name                                                     Social Security Number                             -            -
                                                                                                                                                                                                       Page 2 of 2


                                                                                                                                                                        CitiFinancial, Inc.
PERSONAL LOAN APPLICATION                                                                                                                                               300 St. Paul
PLEASE COMPLETE THE ENTIRE APPLICATION IN BLUE OR BLACK INK.                                                                                                            Baltimore MD, 21202
PLEASE RETAIN A COPY OF THE COMPLETED APPLICATION FOR YOUR RECORDS.

 3. Tell Us About Your Co-borrower (optional) / cont'd


Does your co-borrower reside with you?                     Yes          No
     If co-applicant does NOT reside with you, please complete their
     address information on the following page.--

Street Address                                                                           Apt./Unit Number


City                                                  State                       Zip Code


 How long at your current address?                     Years              Months



Employer Name                                                    Date Hired                  /            /                    (mm / dd / yyyy)




Work Phone                                       Work Extension                                               Gross Salary / Pension                                   Annual           Monthly


I/We certify that the above information is complete and accurate and that this request is not for any business or commercial purpose. You are authorized to investigate my/our credit and employment
histories. I/We certify that I/we are interested in exploring other credit opportunities with you and your affiliates and hereby authorize you, at your sole discretion, to share credit information from time
to time with affiliates and subsidiaries for their independent evaluation.

California Residents: Any married applicant may apply for a separate account.




Signature                                                                                                        Date
       Applicant

Signature                                                                                                        Date
       Co-Applicant



By submitting this Loan application, I acknowledge that I have read the legal information and the Privacy Promise (link to the Privacy Promise). I authorize CitiFinancial to receive and exchange
information and investigate the references and data collected pertinent to my creditworthiness. I represent that the information I have given CitiFinancial regarding my financial condition is
complete and correct and that I have no present intention to file for bankruptcy. I will notify CitiFinancial of any material adverse change in my financial condition.

A consumer report is usually obtained and reviewed in the evaluation of an application. Upon request, you will be informed whether a consumer report was requested and of the name and address
of the credit reporting agency furnishing any such report. Subsequent consumer reports may be requested and used in connection with an update, renewal or extension of credit.

About CitiFinancial
CitiFinancial is a leading provider of personal and home equity loans with more than 1,800 offices across the country. This year CitiFinancial is lending more than $4 billion to individuals and families.
CitiFinancial is a member of Citigroup, a $1 trillion family of financial services companies.

CitiFinancial, Inc.: AZ, CT, DE, HI, ID, IA, KS, KY, LA, ME, MD, MI, MS, MT, NE, NV, NM, NY, NC, ND, OH, OR, PA, RI, SC, SD, TN, TX, UT, VT, VA, WA, WV, WI, WY. AZ: Mortgage Banker License No. BK 0015448.

CitiFinancial Corporation: CO.

CitiFinancial Corporation, LLC: AL.

CitiFinancial Company: NY. NY: Licensed Mortgage Banker - N.Y.S. Banking Department.

CitiFinancial Services, Inc.: CA, CT, FL, GA, IL, IN, MA, MN, MO, NV, NJ, NC, OK, PA, TN, UT, VA. CA: Loans made or arranged pursuant to Department of Corporations California Finance Lenders License.
GA: Georgia Residential Mortgage Registrant No. 6335; principal office, 300 St. Paul Place, Baltimore, MD 21202. NJ: Licensed Mortgage Banker - N.J. Department of Banking and Insurance; principal office,
T. J. Maxx Plaza, 1350 Hooper Avenue, Suite 4-A, Toms River, NJ 08753, Telephone: 732/557-5047. MA: Mortgage Lender License Nos. ML1535, ML1536, ML1537, ML1538, ML1539, ML1540, ML1541, ML1542,
ML1543, ML1544, ML1545, ML1546, ML1547, ML1548, ML1549, ML1550, ML1551, ML1552, ML1553, ML1650, ML1824, ML1900.

CitiFinancial Equity Services, Inc.: FL.

CitiFinancial Consumer Services: NH. Licensed by the New Hampshire Banking Department.

CitiFinancial Consumer Services, Inc.: RI. RI: Licensed as a Lender and Small Loan Lender by Department of Business Regulation.

CitiFinancial of Virginia, Inc.: VA.

CitiFinancial Real Estate Services, Inc.: MS.

Notice to Married Wisconsin Residents: No provision of a marital agreement, unilateral statement, or court decree under Wisconsin's Marital Property Act adversely affects our rights with respect to your
account, unless, before we extend credit to you, you provide us with a copy of it, or we have actual knowledge of the adverse provision when the obligation is incurred.

Notice to Residents of Alaska, Arkansas and Washington, D.C.: CitiFinancial does not have the authority to make loans in these jurisdictions and we are unable to accept applications from residents of these
jurisdictions. We regret any inconvenience to you.

				
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