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GreenSky® Installment Loan Information Form

By submitting a loan application, you, the Applicant, and Co-applicant (if any) agree that you are applying for any product that any financial institution participating in the GreenSky® Program (a "Lender") may offer as part of the GreenSky® Program, regardless of any product your merchant may have specifically discussed with you. The information from this form will be used to submit an application for a GreenSky® Program loan via the Program’s computer application.

Applicant Information

Requested Loan Amount:

First Name

Last Name

Date of Birth (mm/dd/yyyy) (Min. Age 18. 19 in AL.)

Social Security Number

Phone

▢ Mobile Phone Disclosure: If you provide a mobile phone number and check this box, you authorize any financial institution that makes a GreenSky® loan to you and its agents, contractors, successors, assigns, or service providers to contact you at this mobile number and any future mobile number that you provide for your cellular telephone or other wireless device by phone or text message using automated telephone dialing system or artificial or prerecorded voice messages, for any legal purpose, including but not limited to servicing a loan. You may revoke consent at any time by contacting us at 866-936-0602 or P.O. Box 29429, Atlanta, GA 30359.

Street Address P.O Box not accepted.
ACP Program Participants:
call 833-815-6869 to apply.

City

State

Zip Code

Email Address

Email Disclosure: If you provide an email address, the GreenSky® Program, including its lenders and service providers may use it to contact you about GreenSky® and affiliate products, services, special offers and other promotions.

Gross Annual Income

Income Disclosure: Alimony, child support or separate maintenance payments need not be revealed if you do not wish to have them considered as a basis for repaying the loan.
Married Wisconsin Residents: Combine you and your spouse’s information once. Examples: yearly salary (before taxes) alimony, child support, investment income, social security.

Co-Applicant Information

First Name

Last Name

Date of Birth (mm/dd/yyyy) (Min. Age 18. 19 in AL.)

Social Security Number

Phone

▢ Mobile Phone Disclosure: If you provide a mobile phone number and check this box, you authorize any financial institution that makes a GreenSky® loan to you and its agents, contractors, successors, assigns, or service providers to contact you at this mobile number and any future mobile number that you provide for your cellular telephone or other wireless device by phone or text message using automated telephone dialing system or artificial or prerecorded voice messages, for any legal purpose, including but not limited to servicing a loan. You may revoke consent at any time by contacting us at 866-936-0602 or P.O. Box 29429, Atlanta, GA 30359.

Street Address P.O Box not accepted.
ACP Program Participants:
call 833-815-6869 to apply.

City

State

Zip Code

Email Address

Email Disclosure: If you provide an email address, the GreenSky® Program, including its lenders and service providers may use it to contact you about GreenSky® and affiliate products, services, special offers and other promotions.

Gross Annual Income

Income Disclosure: Alimony, child support or separate maintenance payments need not be revealed if you do not wish to have them considered as a basis for repaying the loan.
Married Wisconsin Residents: Combine you and your spouse’s information once. Examples: yearly salary (before taxes) alimony, child support, investment income, social security.

Required for Married Wisconsin Residents

Applicant Spouse’s First Name:

Middle Initial

Applicant Spouse’s Last Name:

Applicant Spouse’s Street Address:

City

State

Zip Code

Co-Applicant Spouse’s First Name:

Middle Initial

Co-Applicant Spouse’s Last Name:

Co-Applicant Spouse’s Street Address:

City 

State

Zip Code

TO BE COMPLETED BY SALES CONSULTANT/MERCHANT


Merchant Number


Requested Plan Number

Applicant Type of ID

  • [ ] Driver’s License
  • [ ] State/Province Issued ID
  • [ ] Military ID
  • [ ] Passport
  • [ ] Tribal Card
  • (please check one)

Name on ID


State


ID Number


ID Expiration Date

Co-Applicant Type of ID

  • [ ] Driver’s License
  • [ ] State/Province Issued ID
  • [ ] Military ID
  • [ ] Passport
  • [ ] Tribal Card
  • (please check one)

Name on ID


State


ID Number


ID Expiration Date

Sales Associate/Merchant Name and Contact Information

Account Opening Disclosures

Please read the following important agreements and disclosures. This is a credit application, and submitting it means that you have read and agree to all the steps described below. These agreements and disclosures can be found online anytime at www.greensky.com/disclosures. Please retain a copy of them for your records.


Definitions: For the purposes of these disclosures, the following definitions apply:

“Lender,” “us,” “we” or “our” shall include any financial institution, and their agents, service providers and representatives, participating in the GreenSky® Loan Program (the “GreenSky® Program”).

“You” or “your” shall include any applicant and any co-applicant collectively, submitting an application for a loan with the GreenSky® Program.

  1. APPLICATION AGREEMENTS AND DISCLOSURES FOR GREENSKY® CONSUMER LOAN PROGRAM

We are providing the following Disclosures to you in connection with your application for a loan from one of the financial institutions offering the GreenSky® Program.

Important Disclosures:

By submitting this application for credit, you agree that you have read and understand the following:

  1. THE FOLLOWING IS IMPORTANT INFORMATION ABOUT PROCEDURES FOR OPENING A NEW ACCOUNT: To help the government fight the funding of terrorism and money laundering activities, Federal law requires all financial institutions to obtain, verify, and record information that identifies each person who opens a new account. What this means for you: When you open an account, we will ask for your name, address, date of birth, and other information that will allow us to identify you. We may also ask to see your driver’s license or other identifying documents.
  2. In providing your income as part of this application, or in providing any subsequent update to your income, you should provide total available wages, retirement benefits, and any income from investments or rental properties. If you include non-taxable income or benefits, you should increase them by 25%. Alimony, child support, or separate maintenance payments is optional and need not be revealed if you do not wish to have it considered as a basis for repaying your loan.
  3. If you request, you will be informed whether a credit report was requested and, if so, the name and address of the consumer reporting agency that furnished the report.
  4. If approved for a loan, you will be required to activate your loan account, and we will ask you to accept your Installment Loan Agreement (“Agreement”) by signing it electronically. The dated electronic record of your acceptance of the Agreement will evidence your signature of the Agreement and have the same legal effect as a physical signature.
  5. Notice to All Applicants, Including New York, Rhode Island and Vermont Residents: A consumer credit report may be requested in connection with this application or in connection with updates, renewals or extensions of credit granted as a result of this application. Upon your request, you will be informed whether or not such a report was requested and, if so, the name and address of the agency that furnished the report.
  6. The following state-specific notices apply, as indicated, to California, Delaware, Maryland, New York, Ohio, Vermont, and Wisconsin applicants:

    California Residents: If you are married, you may apply for a separate account.
    Delaware Residents: Service charges not in excess of those permitted by law will be charged on the outstanding balances from month to month.
    Maryland Residents: Finance charges will be made in amounts or at rates not in excess of those permitted by law.
    New York Residents: New York residents may contact the New York State Department of Financial Services by telephone or visit its website for free information on comparative credit card rates, fees, and grace periods. You can call the New York State Department of Financial Services at 1-800-342-3736 or visit www.dfs.ny.gov.
    Ohio Residents: The Ohio laws against discrimination require that all creditors make credit equally available to all credit worthy customers, and that credit reporting agencies maintain separate credit histories on each individual upon request. The Ohio civil rights commission administers compliance with this law.
    Vermont Residents: We are engaged in loan production.
    Married Wisconsin Residents: If you are applying for individual credit or joint credit with someone other than your spouse, and your spouse also lives in Wisconsin, combine your financial information with your spouse’s financial information. No provision of any marital property agreement, unilateral statement under Section 766.59 of the Wisconsin statutes or court order under section 766.70 adversely affects the interest of the lender, unless the lender, prior to the time credit is granted, is furnished a copy of the agreement, statement or decree or has actual knowledge of the adverse provision when the obligation to the lender is incurred. If married, you understand that your lender must inform your spouse if a credit account is opened for you.

Important Applicant Agreements:
By submitting this application for credit, you agree to the following:

  1. You are applying for any product that we may offer as part of the GreenSky® Program regardless of any product your merchant may have specifically discussed with you.
  2. All of the statements (whether verbally or written) communicated to us and to your merchant related to this application are true and correct and are made for the purposes of obtaining credit.
  3. If more than one applicant is applying, each applicant intends to apply for joint credit and none is a co-signer (a “co-signer” is a person who agrees to be liable for the debt of another person without receiving the benefit of the loan; a “joint applicant” is a person who intends to apply for joint credit and will receive the benefit of the loan). Although we allow joint applicants to apply for joint credit, we do not allow borrowers to use “co-signers”.
  4. You will provide additional financial information upon request.
  5. You are requesting that your lender issue you a shopping pass card if your credit application is approved.

By submitting this loan application, you expressly authorize us to:

  1. Obtain a credit report on you for this application and for any other legal purpose, including any account update, extension of credit, or review or collection of your loan.
  2. Share with your merchant, and manufacturer, including, respectively for each, any service providers, parent/affiliate entities, and franchisors/franchisees: (i) the application information (including our credit decision, and your credit score), and (ii) if approved, the loan information (including your approved credit limit, loan status, the repayment period, approved APR, account number, and any loan disbursement transactions).
  3. Share with any co-applicant loan related information, including but not limited to, your credit decision, proposed loan terms, and personal credit scores, which will have the same effect as personal delivery to you.
  4. Contact you about our products, services, special offers and other promotions at any email address provided to us now or in the future. Contact you at any mobile number and any future mobile number that you provide by phone or text message using an automated telephone dialing system or artificial or prerecorded voices, for any legal purpose, including but not limited to, servicing and collecting any loan. You may revoke your consent at any time by contacting us at 1-866-936-0602 or P.O. Box 2730, Alpharetta, GA 30023.
  5. Share with your merchant your contact information including address, email address, and telephone number.
  6. Contact your wireless operator (AT&T, Sprint, T-Mobile, US Cellular, Verizon, or any other branded wireless operator) to disclose your mobile number, name, address, email, network status, customer type, customer role, billing type, mobile device identifiers (IMSI and IMEI) and other subscriber status and device details, if available, to our third party service provider, solely to verify your identity and prevent fraud for the duration of the business relationship. See the GreenSky® Program Privacy Policy https://www.greensky.com/privacy-policy for how we treat data collected online through the GreenSky® Program websites, online through the GreenSky® Program mobile applications that link to this Privacy Policy, and offline via mail, telephone, and in person. If you are approved for a loan through the GreenSky® Program, your information may also be subject to a privacy policy specific to your lender under the GreenSky®Program.

  1. MARKETING DISCLOSURES AND CONSENT FOR COLLECTION/RECEIPT OF INFORMATION FOR MARKETING PURPOSES

In addition to providing personal information in connection with a GreenSky® Program Loan application, you agree that you are providing a copy of any information, including personally-identifiable information (“PII”), to GreenSky Marketing, LLC for its collection, use, and disclosure consistent with the GreenSky® Program Privacy Policy at https://www.greensky.com/privacy-policy, including, but not limited to, using and sharing such information with unaffiliated third-parties for their marketing purposes. You also authorize your GreenSky® Program lender to provide GreenSky Marketing, LLC with all information about you and your GreenSky® Program loan, including, but not limited to, details about your loan and loan performance so that GreenSky Marketing, LLC may use and/or disclose such information for GreenSky Marketing, LLC (and/or its affiliates and third-parties) to provide you with various marketing offers. You understand and agree that your written instruction and authorizations are voluntary and shall remain in effect until you revoke them by submitting an opt-out request through the webform, or by contacting us at 833-215-6867.

GreenSky® Program NMLS #1416362

Application Submission Authorization

You, the GreenSky® Program loan Applicant/Co-Applicant, have read and accepted the important Account Opening Disclosures provided to you above. You also agree to the GreenSky® Program Privacy Policy available at www.greensky.com/privacy-policy and Consent to Electronic Records and Communications available at www.greensky.com/information and agree to receive electronic documents in connection with any loan obtained as a result of this application. You also agree to participate in the GS Marketing program, subject to the GS Marketing Privacy Policy at www.gskymarketing.com/privacy-policy, independently of your participation in the GreenSky® Program and provide your specific consents as described in the Account Opening Disclosures above.

You, the Applicant/Co-Applicant, authorize Lender and its representatives, successors, and assigns to investigate your creditworthiness and obtain a credit report for you for any lawful purpose, including, but not limited to, any extension of credit, renewal, servicing and collections. Upon request, Lender will inform applicant of whether a credit report was obtained and if a report was obtained, the names and addresses of the credit reporting agencies that furnished the report.

By signing below, you certify that the Application Information is true and accurate.

Language Selection

▢ Please select this box if you conducted any part of the discussion about your GreenSky® application or loan in Spanish, or would otherwise like a copy of your loan agreement in Spanish.
Por favor, marque esta casilla si ha llevado adelante alguna parte de la discusión sobre su solicitud o préstamo GreenSky® en español, o si desea una copia de su contrato de préstamo en español.

Applicant Signature

x

Applicant's Signature


Date

Please provide a government issued picture ID to the Associate/Merchant.

Co-Applicant Signature

If signed, Applicant and Co-Applicant intend to apply for joint credit.

x

Co-Applicant's Signature


Date

Please provide a government issued picture ID to the Associate/Merchant.

NMLS #1416362
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Online: www.greensky.com • Email: service@greensky.com • 866-936-0602

GSCP Installment Application Information Form
02042021