Loan Application for Teton Financial Step 1 of 2 - Terms and Conditions 50% YOU MUST READ AND AGREE TO THE TERMS OF THIS LOAN FEE SCHEDULE BEFORE YOU WILL BE ALLOWED TO SUBMIT A LOAN APPLICATION EXAMPLES OF TOTAL COSTS: Cash advance $1,000.00 Amount Financed $1,000.00 Payable in 12 monthly installments of $100.46 per month Finance charge $205.52 Total of payments $1,205.52, APR 36.00% Cash advance $10,000.00 Title registration fee $8.00 Amount financed $10,008.00 Payable in 36 monthly installments of $377.05 per month Finance charge $3,565.80 Total of payments $13,573.80, APR 21.00%. DEFERRAL CHARGE: The Lender may, at any time, grant a deferral postponing the scheduled due date of the earliest unpaid installment and all subsequent installments as originally scheduled or as previously deferred for a period of time determined by the Lender in exchange for a deferral charge. The deferral charge is computed in accordance with Section 3 2-5-301(3)(a),(b), and(c), MCA. LATE CHARGE: If any payment is more than 10 days past due, a late charge of 5 cents may be collected on each $1.00 or part of $1.00 of the unpaid amount of the payment, or $15.00 whichever is greater. No late charge shall exceed $50.00. ATTORNEY FEES: You agree to pay reasonable attorney fees and court costs arising from the collection or enforcement of this Combination Note, Security Agreement, and Federal Disclosure Statement, provided Lender receives a favorable final judgment. DISHONORED CHECK FEE: In the event any check, draft or instrument I give Lender as a full or partial payment under this agreement is dishonored, returned to Lender as an insufficient funds instrument or dishonored for any other reason, I will pay to Lender a fee of $25.00.Acceptance*I have read, understand, and accept these terms. Yes No, I do not accept these terms Car | Consolidation | Personal Loan Application To apply for a loan, please fill out this application. We will call you and ask you more questions about your finances. We also pull a credit report and verify employment. APPLICANT INFORMATIONFIRST NAME* LAST NAME* Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code NUMBER OF YEARS AT ADDRESS* AMOUNT OF RENT OR MORTGAGE PAYMENT* LAST 4 NUMBERS OF SOCIAL SECURITY #* DATE OF BIRTH* Month Day Year Email* TELEPHONE OR CELL PHONE (daytime)*TELEPHONE OR CELL PHONE (After 5pm if different)PROPERTY INFORMATIONYEAR of AUTO MAKE OF AUTOMOBILE MODEL OF AUTOMOBILE MILEAGE VEHICLE IDENTIFICATION NUMBER (VIN) JOB INFORMATIONEMPLOYER* EMPLOYER PHONE NUMBER EMPLOYER STREET ADDRESS EMPLOYER CITY EMPLOYER STATEIdahoAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificPOSITION HELD MONTHLY NET (AFTER TAXES)* LENGTH OF EMPLOYMENT* LOAN REQUEST INFORMATIONTYPE OF LOAN REQUESTED*Please SelectAUTO LOANCONSOLIDATION LOANPERSONAL LOANLOAN AMOUNT REQUESTED* COMMENTSPlease type any comments here.I AUTHORIZE TETON FINANCIAL LOANS TO VERIFY MY CREDIT AND EMPLOYMENT HISTORY* YES, I AUTHORIZE THESE CHECKS NO, I DO NOT AUTHORIZE CHECK, PLEASE CANCEL APPLICATION EmailThis field is for validation purposes and should be left unchanged.