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1. Customer Information (questions?)

Loan Amount:

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*First Name

Please provide your first name

*Last Name

Please provide your last name

*Street Address

Please provide your street address

Apt. or Suite #

*Zip Code

Please provide your zip code

Home Owner

Please select home owner option

Time At Address

Please select time at address option

Active Military

Please select active military option

2. Contact Information (questions?)

*Email Address

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*Home Phone #

Please provide a valid phone number (valid format xxx-xxx-xxxx)

3. Employment Information (questions?)

Type of Income

Please select type of income option

Monthly Income

Please select monthly income option

*Employer Name

Please provide employer name

*Employer's Phone #

Please provide employer phone number (valid format xxx-xxx-xxxx)

Months Employed

Please select months employed option

Direct Deposit

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Pay Frequency

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*Upcoming Paydate (must be no later than 60 days)

Please select month

Please select day

Please select year

4. Bank Information (questions?)

Account Type

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*Bank Name

Please provide a bank name

Months With Bank

Please select months with bank option

*Bank ABA #

Please provide a valid bank routing number

*Bank Account #

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5. Security Information (questions?)

*Date of Birth

Please select month of birth

Please select day of birth

Please select year of birth

*Driver's License #

Please provide a driver license

Driver's License State

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*Social Security #

Invalid social security number. (valid format XXX-XX-XXXX)

Credit Score

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Credit card debt?

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Tribal Lake Lending

Our mission is to simplify the loan acquisition process, providing a seamless, user-friendly platform that connects borrowers with a curated selection of direct tribal lenders.

9620 Las Vegas Blvd S Las Vegas, NV 89123

702 805 0549

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