Apply Fruitland -

Canyon Financial, your second chance finance specialist

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Apply Fruitland





    PERSONAL INFORMATION








    Has Co-Applicant?  








    (Current Residence)





    Less than 3 years at current?  

    (Street – City – State – Zip)


    (Street – City – State – Zip)

    EMPLOYMENT INFORMATION (Please include 3 years of history)

















    *Notice: Income from alimony, child support or separate maintenance payments need not be revealed if you chose not to have it considered.

    EMPLOYMENT INFORMATION – CO-APPLICANT (Please include 3 years of history)

















    *Notice: Income from alimony, child support or separate maintenance payments need not be revealed if you chose not to have it considered.

    COLLATERAL









    YesNo
    YesNo
    YesNo

    You have additional collateral?  









    YesNo
    YesNo
    YesNo


    REFERENCES













    FINANCIAL INFORMATION

    YesNo
    YesNo

    Type Of Expense Creditor Balance Minimum Payment Comments
    Housing Pmt/Rent
    Auto Loan
    Auto Ins.
    Child Support
    Daycare
    Medical
    Credit Cards
    Gas Bill (Heat)
    Sewer/Water/Trash
    Power Bill
    Cell Phone
    Cable/Dish/Internet
    Student Loans
    Rent To Owns
    Check Cashing Loans
    Payday Loans
    Title Loans
    Federal Tax Liens
    State Tax Liens
    Garnishments Groceries (Food, Household Items)
    Other (Explain)
    Canyon Financial Proposed Loan PMT
    Locations