Please fill out the following form. (Items in BOLD
are required.)
Primary
Applicant
(Type your name as you would like it to appear on the loan.) First: Middle:
Last:
Suffix: (Jr, III, etc.) Social Security #:
Date of Birth (MM/DD/YYYY):
Mother's Maiden Name or other code word phrase (for security
purposes): Address 1:
(include APT, LOT etc.)
Address 2: City: State:
ZIP:
Years there (YY):
Rent/Mortgage Payment: $.00
Rent/Buy/Own: Home Phone: ()
-
Work Phone: ()
-
Employer:
Years there (YY):
Job Title:
Position: Your Annual Salary: $.00
Email Address:
Co-Applicant (Optional) First:
Middle:
Last:
Suffix: Social Security #:
Date of Birth (MM/DD/YYYY):
Relationship to Applicant:
Check
if same address as primary applicant Address 1:
(include APT, LOT etc.)
Address 2: City:
State:
ZIP:
Rent/Buy/Own: Home Phone: ()
-
Work Phone: ()
-
Employer: Years
there (YY):
Job Title:
Position: Co- Annual Salary: $.00
Other Income: $.00***
Source of Other Income:
Total Household Income: $.00***
***Alimony, Child
Support, or Separate Maintenance income need not be revealed if you do
not wish it considered as a basis for repayment.
Product Type: Order # (if available):
Loan Amount Requested: $
Term of Loan:
Check if
shipping address is same as primary applicant address. Shipping Address:
(include APT, LOT
etc.) City:
State:
ZIP:
I am 18 or older.
Landscapes 2 Go., its affiliates and marketing associates may monitor
and/or record my conversations with their representatives or the
representatives of any of those companies. I authorize Landscapes 2
Go to check my
credit, employment, and other information to process my application, service
my account, and manage its relationship with me. I authorize
Landscapes 2 Go to
share such information and credit experience with others to the extent
permitted by law.I consent to the sharing of such information
with Landscapes 2 Go even if I later opt my account out of information sharing with
other companies.My right to opt my account out of some of this
sharing is described in Landscapes 2 Go's Privacy Notice. If I receive a loan, a
Privacy Notice will be delivered to me. If I
accept or use the account, I do so subject to the terms of this application
and the Account Agreement (with its arbitration provisions), including
supplemental agreement terms. If I am approved and do not use the approval
screen cancellation option by 2:00 a.m. Eastern Time, I will be provided
with an account and all approved transactions which I have authorized, such
as any balance transfers, direct deposit or other automatic transaction,
will be processed. If Landscapes 2 Go has received another credit application from me
within 90 days, Landscapes 2 Go may consider this a duplicate.
By electronically submitting this application, I agree to each of the
conditions described above and to be bound by the terms of the Account
Agreement, including arbitration.
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