Prequalification Form

Welcome to's free prequalification system. By authorizing to review your current credit information, you can receive a response on-line that will give you an idea of how much you can afford. Or, if you would prefer to speak to a Loan Officer, you can call (888) 226-5892. Please note that at this time, you must be a resident of Illinois to submit a prequalifier.

Credit Access Authorization
To process your request, we will need to collect and use information that will allow us to access your credit bureau information.

Do you authorize to access your credit information?

Authorize     Deny

All in One Loan/Credit Prequalifier

The information you provide here will help us establish where you are now and where you want to be. This information is confidential and will be used for the sole purpose of preparing personal financing option proposals for your review.

You may submit this information over the Internet by filling in this form and clicking the Submit button below, or you may choose to print out the completed form and fax it to (217) 342-9449.

Primary Member's Name:

Birthdate: //

Social Security Number: --

Primary Account Number:

Daytime Telephone Number:

Evening Telephone Number:

Email Address:





How long at this address?: mos. yrs.

Amount Requesting: Type of Loan:

Number of dependents: Ages of dependents (for example, 3,7,11):

Driver's License Number: State issued:


Current Gross Salary (monthly):

Date Employed: // Job Title:

If less than two years, list previous employer and length of employment: Employer: Job Title:

Dates of employment: from: // to: //

Other Personal Income. You do not have to include alimony, child support, or maintenance, unless you want us to consider it in granting credit:

Annually: Monthly:


Assets and Credit Information:

Savings: 401K: IRA:


In order to finalize your loan you will be required to complete a more thorough written application that will be mailed to you. We will provide you with all terms, conditions and fees before accepting your signed application.