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Borrower Application Form 

​​Please complete the Borrower Application Form by either filling it out below or downloading the PDF below and email it back to us. Be sure to fill out all sections clearly and completely.​

Borrower Application Form

Birthday
Are you Jewish?
Yes (born to a Jewish mother)
Yes, (I converted to Judaism)
No
No, but I'm in the process of conversion
Marital Status:
Unmarried (includes single, divorced and widowed—does not include registered domestic partner)
Married or registered partner under the California Domestic Partnership Law
Separated
Do you:
Rent
Own Home

Birthplace:

U.S. Citizen
Yes
No
Have you ever used another name?
No
Yes
If your loan is approved, should we send your check to the address above?
Yes
No, Send to:
Annual income range
$20,000-$40,000
$41,000-$70,000
$71,000-$100,000
$101,000-$150,000
Over $150,000

Instructions to Married or Registered Domestic Partner Applicants: Please answer all questions pertaining to your spouse or partner if he or she is also applying for this loan. If you have a registered domestic partner, please treat all questions relating to a “spouse” as if they related to your partner. Unless you indicate otherwise, we will assume that all property listed is community property and that all debts listed for you and your spouse or partner are community obligations.

Annual income range
$20,000-$40,000
$41,000-$70,000
$71,000-$100,000
$101,000-$150,000
Over $150,000
Have you applied for and/or received any loans, grants, etc. from any other source for this purpose?
Yes
No

By signing, I:

1. Certify that the information on both pages of this application is true and complete as of the below date(s).

2. Agree that this application is the property of OC Jewish Interest Free Loans and need not be returned to me.

3. Authorize OC Jewish Interest Free Loans to verify the accuracy and completeness of all information above from any source OC Jewish Interest Free Loans chooses. If I am married or am a registered domestic partner and am applying for this loan in my name alone, this authorization extends to verifying information about my spouse or partner.

4. Authorize OC Jewish Interest Free Loans to answer questions from, and to furnish information to, others about OC Jewish Interest Free Loan’s experience with me and to discuss all aspects of this application and my loan with each person who cosigns my loan.

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