Loan Information

Name:


Email:


SSN:


Date Of Birth:
Month January February March April May June July August September October November December Day 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Year 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923 1922 1921 1920 1919 1918 1917 1916 1915 1914 1913 1912 1911 1910 1909 1908 1907 1906 1905 1904 1903 1901 1900

State:
State Alabama Alaska Arizona California Florida Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Michigan Mississippi Missouri Nebraska Nevada New Mexico Ohio Oklahoma Rhode Island South Carolina Tennessee Texas Utah Washington Wisconsin Wyoming
Zip Code:


Funding Type:
Funding Type ACH

By checking this box, you agree to receive electronic disclosures via email.
I acknowledge and understand Plain Green, LLC, is a wholly owned company of the Chippewa Cree Tribe of Rocky Boy’s Reservation, Montana; a Native American Tribe federally recognized by the government of the United States of America, and we operate within the boundaries of the reservation. You may reside in a state that does not recognize the sovereign lending authority of the Chippewa Cree Tribal Government and may consider the products and services offered by Plain Green as void under state law. By entering into an agreement with Plain Green, you are availing yourself upon the jurisdiction of the Tribe and fully understand and consent that any agreement entered into is governed by all applicable federal law and the laws and lending codes enacted by the Tribe’s federally recognized sovereign government. I understand that by clicking Submit below, I am providing “written instructions” to PG under the Fair Credit Reporting Act authorizing PG to obtain information from my personal credit profile or other information from credit reporting agencies in connection with this loan application.
You acknowledge that by completing and submitting the website application that you are applying for a Loan. We verify applicant information through national databases including, but not limited to, Clarity, Experian, TransUnion, FactorTrust, DataX, and Equifax and we may pull your credit in order to determine your eligibility and ability to repay.
By submitting this form, you are giving your express written consent for Plain Green, LLC’s network of lenders to contact you regarding financial programs and services that you might qualify for using email, telephone or text – including use of automated technology, for calls or texts to the number you provided here. This consent is not required to purchase goods or services. Click here to see our full Privacy Policy.