Applicant Information |
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Applicant Employer Information |
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Additional Information |
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Nearest Relative not living with you and not the Co-Applicant (if any) |
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Co-Applicant Information (if applicable) |
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Co-Applicant Employer Information |
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Additional Information |
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Nearest Relative not living with you and not the Applicant (if any) |
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Procedure Information |
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Terms and Conditions
All the information on this form is complete, correct and provided to Cogent Financial Group (Cogent) to obtain an installment loan or credit loan. I/we authorize Cogent to investigate credit and employment history and to report the credit experience of any party or authorized user to consumer reporting agencies and others. I/we understand that Cogent will retain this application whether or not it is approved. I/we understand that if the application is for a secured loan by real property that additional information is required. I/we certify that I am/we are 18 years or older and have completed the application questions accurately at any time after this application and/or during my/our relationship with Cogent. I/we authorize Cogent to obtain information concerning my/our employment and credit standing and authorize my/our employer, banks and/or other listed references to release information to Cogent. Cogent may review from time to time my/our eligibility for any credit extended on the account and may provide information about me/us to others. If I/we designate other authorized users, credit bureaus may receive account information on the authorized users in each users name. I/we agree to notify Cogent immediately upon any material change in the information I/we provided herein.
I/we affirm that each of the answers given to the foregoing questions is true and correct and that the foregoing is a true and correct statement of my/our financial condition. It is a federal criminal offense to knowingly make any false statement or report, or to willfully overvalue any property for the purpose of influencing Cogent to act on this application.
I/we understand and agree to the terms and conditions of this application
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