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GreenSky® Prequalification Request Form

A soft inquiry will be performed on your credit report, which won’t impact your credit score. Soft inquiries can only be seen by you. When you accept a loan offer and submit it for review, a hard inquiry will be performed, which may impact your credit score and can be viewed by third parties. To check your rate and view offers, please complete the application below.

By submitting this prequalification request, you are seeking prequalification 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. The information from this form will be used to submit a prequalification request to the GreenSky® Program via the Program’s online submission process.

Applicant Information

Amount Requested:

First Name

Last Name

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

Social Security Number

Mobile Phone

▢ By selecting this checkbox, you agree to the following: By providing your number, you agree that we, our agents, or our affiliates may use it to contact you about any product(s) or service(s) you obtain (or are obtaining) from us including using an automated dialing system, text message, or prerecorded messages, even if you may incur charges.

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

City

State

Zip Code

Email Address

Email Disclosure: We may use this email address to send you information about your account and to contact you about our services, special offers and other promotions. You understand email is a not a secure means of communication and we are not responsible for any improper disclosure of the contents of an email properly addressed to you.

Gross Annual Income

Income Disclosure: List your total wages, retirement benefits and any income from investments or rental properties. Alimony, child support or separate maintenance is optional. If you include non-taxable income/benefits increase them by 25%.
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

Mobile Phone

▢ By selecting this checkbox, you agree to the following: By providing your number, you agree that we, our agents, or our affiliates may use it to contact you about any product(s) or service(s) you obtain (or are obtaining) from us including using an automated dialing system, text message, or prerecorded messages, even if you may incur charges.

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

City

State

Zip Code

Email Address

Email Disclosure: We may use this email address to send you information about your account and to contact you about our services, special offers and other promotions. You understand email is a not a secure means of communication and we are not responsible for any improper disclosure of the contents of an email properly addressed to you.

Gross Annual Income

Income Disclosure: List your total wages, retirement benefits and any income from investments or rental properties. Alimony, child support or separate maintenance is optional. If you include non-taxable income/benefits increase them by 25%.
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

Disclosure Agreement

You, the applicant, agree and understand the following notice:

  1. Prequalification Request: This prequalification request is being submitted to the financial institutions participating in the GreenSky® Loan Program (the “GreenSky® Program”).

    • You acknowledge you have read and agree to the Consent to Electronic Records and Communications at https://www.greensky.com/information, and you agree to receive electronic documents in connection with this prequalification request, any loan application you submit and any loan obtained as a result of any such application. In addition, you acknowledge you have read and agree to the (a) the GreenSky® Program Privacy Policy at https://www.greensky.com/privacy-policy, and (b) the GreenSky® Program Arbitration Agreement at https://www.greensky.com/disclosures#arbitration, which contains an agreement to individually arbitrate claims related to this prequalification request, any loan application and any loan resulting from any such application, your participation in the GreenSky® Program and other matters set forth therein.
    • You are providing ‘written instructions’ under the Fair Credit Reporting Act to the GreenSky® Program, the financial institutions participating in the GreenSky® Program and their agents, service providers and representatives authorizing such persons to obtain information from your personal credit profile or other information from Experian. You authorize the GreenSky® Program and such persons to obtain such information solely to conduct a prequalification for credit. You expressly authorize the GreenSky® Program and such persons to share with your Merchant, any sponsor of your Merchant and any manufacturer, including, respectively for each, any service providers, parent/affiliate entities, and franchisors/franchisees, the Prequalification decision, including the prequalified credit limit, loan terms, and prequalified APR.
    • After clicking “submit”, a soft inquiry will be performed on your credit report, which will not impact your credit score. Soft inquiries can only be seen by you. If prequalified, you may be presented with one or more loan plans for which you can submit a formal loan application; however, being prequalified for a loan plan is not a guaranty that you will ultimately be approved for a loan. If you are prequalified and want to proceed further with being evaluated for a loan, then you will select a prequalification plan and submit your loan application for review, a hard inquiry will be performed, which may impact your credit score and can be viewed by third parties.

  2. Marketing Disclosures and Consent for Collection/Receipt of Information for Marketing Purposes

    • In addition to providing personal information in connection with a GreenSky® Program prequalification request, by clicking this checkbox, 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 are agreeing to the GreenSky Marketing, LLC Privacy Notice at https://www.greensky.com/privacy/greensky-marketing.pdf and, if you submit a loan application for review and are approved for a GreenSky® Program loan, 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 various marketing offers to you (independently of your participation in the GreenSky® Program). 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 at https://www.gskymarketing.com/privacy-form, or by contacting us at 833-215-6867.

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

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.