STEP 2 OF 3

Tell Us a Little Bit About Your Employment

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All information is kept in strict confidence.

Name

Name of Employer

Address of Employer

Length of Employment - Years, Months

Hours of Work

Net Income Per Pay Period

Pay Frequency

Weekly

Bi-Weekly

1st & 15th

Once a month

Other

Next Pay Date

Do you have Direct Deposit?

Yes

No

Do you have any wage garnishments?

Yes

No

Employer Phone Number

Supervisor Name & Title

Supervisor Phone Number

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customerservice@loan-n-go.com

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