Friendly Banker Payday Loan

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Important Notice

Friendly Banker is currently not serving residents of the following state:

Georgia.

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Please fill out application completely to help us process your Friendly Banker loan.

Employer Name

Employer Address

Employer City

Employer State

Employer Zip

Employer Phone

Ext.

How Long Employed?

Years Months

Position

Department

Gross Monthly Income

How Often You Get Paid

Any garnishments being deducted from your payroll check currently? If yes, how much per check?

Yes No

Bank Name

Bank Routing Number

Bank Account Number

Bank Account Type

Checking Savings

Opened How Long?

Years Months

Direct Deposit?

Yes No

Current Account Balance

Approximate number of monthly transactions including checks written, deposits and withdrawals.

Number of items returned for non sufficient funds

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