Personal loans & lines of credit

Financing Application

Complete each section carefully. Required fields are marked with an asterisk. Submitting an application does not guarantee approval.

● Secure submissionYour application and uploaded documents are encrypted and are not sent through ordinary email.

Application received

Thank you for applying.

Your confirmation number is:

Keep this number for your records. Ozriel Capital may contact you if additional information is required.

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FinancingApplicantResidenceIncome & DocumentsReview & Consent

Financing Request

Tell us which product you are requesting and how you plan to use the funds.

Product requested *

Requested amount or credit limit *

Purpose of financing *

Applicant Information

Enter your information exactly as it appears on your government-issued identification.

First name *

Middle name

Last name *

Suffix

Date of birth *

Social Security number *Encrypted before secure storage. Never included in email.

Email address *

Phone number *

Residence Information

Provide your current residence and housing obligation.

Street address *

Apartment or unit

City *

State *Product availability and terms vary by state.

ZIP code *

Years at current address *

Housing status *

Monthly housing payment *

Previous address, if at current address under two years

Previous city

Previous state

Previous ZIP

Employment, Income & Documents

Income from alimony, child support, or separate maintenance does not need to be disclosed unless you want it considered.

Employer or income source *

Job title or occupation *

Employment start date *

Employer phone

Employer address

Gross income *

Income frequency *

Other income

Other-income source

Bank or financial institution

Account type

Estimated monthly debt payments

Government-issued photo ID *PDF, JPG, or PNG; maximum 8 MB.

Proof of income *Recent pay statement or other appropriate documentation; maximum 8 MB.

Personal reference name

Personal reference phone

Review, Authorization & Consent

Review your entries before submitting. You may use Back to make corrections.

Important: This is an application, not a loan agreement or promise to extend credit. Product availability, amount or credit limit, rate, fees, repayment obligations, and other terms will be provided if an offer is made.

Applicant certification. I certify that the information and documents submitted are true, complete, and accurate to the best of my knowledge. I understand that material misrepresentations may result in denial or other lawful action.

Verification authorization. I authorize Ozriel Capital LLC and its authorized service providers to verify information provided in this application, including identity, employment, income, residence, and other information relevant to evaluating this request. Where legally permitted and applicable to the review, this may include obtaining consumer information from third-party sources.

Electronic records and signatures. I consent to receive application-related disclosures, notices, and records electronically and to use electronic signatures. I confirm that I can access, retain, and print electronic records. See the E-SIGN Consent.

Privacy and application notices. I acknowledge the Privacy Policy, Application Authorization, Loan Disclosures, State Availability, and Equal Credit Opportunity Notice.

Equal Credit Opportunity: Ozriel Capital LLC does not discriminate against an applicant on a prohibited basis. Additional information appears in the Equal Credit Opportunity Notice.

Missouri Finance License No. 365-26-10148. Submission is subject to the legal notices and state availability information linked above.