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CUSTOMER INFORMATION Información de solicitante

          First Name
          Primer nombre
          *
        
          Last Name
          Apellido
          *
        
          SSN
          SSN
          
          *
          
             -  - 
          
            E-mail
            Correo electrónico
            
            *
            
            Birth Date
            Fecha de nacimiento
            
            *
            
          Valid Driver's License or State ID Number
          Numero de licencia
          
          State Issued
          Estado
          
            Home Phone
            Teléfono de casa
            
            Cell Phone
            Numero de celular
            
            *
            
            Best Time To Call
            La mejor hora de contacto
            
            Address
            Dirección
            
            *
            
            City
            Ciudad
            
            *
            
            State
            Estado
            
            *
            
            Zip
            Código postal
            
            *
            
            Time At Address
            Tiempo en residencia
            
            Own/Rent
            Esta rentando o poseeуn
            
              RentOwn

BANKING INFORMATION Información bancaria

Other bank account Other bank account

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INCOME & EMPLOYMENT INFORMATION Ingresos y empleo información

Income from alimony, child support or separate maintenance payments need not be disclosed if you don't wish us to consider this as a source of repayment. Ingresos por manutención de menores o pensión matrimonial u otros ingresos no es necesario declarar esta información si no va hacer utilizado como forma de pago.

Other Income Otro tipo de saldo

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MILITARY Militar

Federal law provides important protections to active duty members of the Armed Forces and their dependents. To ensure that these protections are provided to eligible applicants, we require you to sign one of the following statements as applicable: La ley federal ofrece protections importantes a los miembros activos de las fuerzas armadas y sus dependientes. Para aseguramos de que estas protectiones sean dadas a aplicantes elegibles, requerimos que firme una de las siguientes lineas: *

Yes

I AM a regular or reserve member of the Army, Navy, Marine Corps, Air Force, or Coast Guard, serving on active duty under a call or order that does not specify a period of 30 days or fewer.

Soy un miembro de la reserva de las fuerzas armadas, fuerza naval, cuerpo marinos, fuerza aerea o guarda costera sirviendo actualmente segun sea requerido u orden que no especifica un periodo de 30 dias o mas.

- or -

I AM a dependent of a member of the Armed Forces on active duty as described above, because I am the member's spouse, the member's child under the age of eighteen years old, or I am an individual for whom the member provided more than one-half of my financial support for 180 days immediately preceding today's date.

Soy un dependiente de un miembro de las Fuerzas Armadas sirviendo actualmente como lo explique arriba porque soy esposa (o) de un miembro, el hijo del miembro es menor de dieciocho años, o un sujeto para quien el miembro le mas de la mitad de apoyo financiero por 180 dias a partir de hoy.

I AM NOT a regular or reserve member of the Army, Navy, Marine Corps, Air Force, or Coast Guard, serving on active duty under a call or order that does not specify a period of 30 days or fewer (or a dependent of such a member).

No soy un miembro de la reserva de las fuerzas armadas, fuerza naval, cuerpo marinos, fuerza aerea o guarda costera sirviendo actualmente segun sea requerido u orden que no especifica un periodo de 30 dias o mas (o un dependiente de tal miembro).

TEXT MESSAGE COMMUNICATION Comunicados mediante mensaje de texto

Text Message Communication: Text Message Communication: *

Yes

I agree to receive notifications regarding my account via text message.

Acepto recibir notificaciones sobre mi cuenta a través mensajes de texto.

I do not want to receive notifications regarding my account via text message.

No quiero recibir notificaciones sobre mi cuenta a través de mensajes de texto.

ADVERTISING PUBLICIDAD

How did you hear about us? Como se entero de nosotros?

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LOAN INFORMATION Información de solicitud

Loan Amount Cantidad que solicita *

Please Note: This is an expensive form of borrowing and it is not intended to be a long term financial solution. Examples of emergency reasons why these loans might be used include unexpected emergencies, car repair bills, medical care, or essential travel expenses. An example of our loan charges is a $200 loan with installments of $66.06 about every 14 days (bi-weekly), 148 days overall for a total of 10 installments and an overall finance charge of $460.41 equalling an APR of 673.23%.

All installment loans are underwritten by WLCC Lending BGL doing business as Bison Green Lending. Bison Green Lending is a Native American owned business operating within the interior boundaries of the Pine Ridge Reservation of the Oglala Sioux Tribe, a sovereign nation located in the United States. WLCC Lending BGA dba Bison Green Lending is an instrumentality and limited liability company which abides by all applicable federal laws, and by all regulations as established by the Oglala Sioux Tribe of South Dakota.

Typically Bison Green Lending reviews your information in real-time to determine whether your information meets our lending criteria. You acknowledge that by completing and submitting the website application that you are applying for a loan. We verify applicant information through national databases including, but not limited to, Clarity and Factor Trust and we may pull your credit in order to determine your eligibility and ability to repay.

Bison Green Lending does not lend to residents of CT, IL, MN, NY, SD, VA, VT, WV, MD, Guam, Puerto Rico. Availability of installment loans are subject to change at any time at the sole discretion of Bison Green Lending.

* Cutoff time for same-day funding is 1:30 pm MST and costs an additional $20 which is added to your first payment. The cutoff time for ACH is 3 pm MST and comes with no additional cost. Same-day funding is generally received before the end of the business day that the loan is approved, and ACH funding is generally received before the end of the next business day.