Application

Medical Finance Partners, LLC
a loan processing company

Got Body Get Beauty Get Financed

Application

MFP Credit Application

MFP will send your application request to multiple lenders and shop for the most competitive rates. We can usually get a pre-approval decision from most lenders in 5 minutes or less.
* Required fields


Provider Information
*Loan Amount:	(example $1,500.00)
*Have you selected a Provider yet?:
Provider Name:	(if yes, please provide us with their information)
Provider Address:
Provider City, State Zip Code:
Provider Phone:
Provider's Primary Contact Person:
Applicant Information
*First Name:
Middle Initial:
*Last Name:
*Mother's Maiden Name:
*Social Security Number:	(555-55-5555)
*Birth Date:	(mm/dd/yyyy)
*Email:
*Address Street 1:
Address Street 2:
*City:
*State:
*Zip Code:	(5 digits)
*Time at Current Address:	(years and months)
*Do you:
*Monthly Payment:	(example $1,200.00)
*Home Phone:
*Cell Phone:





Employer Information
*Employer:
*Position:
*Gross Monthly Income:	(example $2,500.00)
*Time at Current Employer:	(years and months)
*Employer's Address:
*Employer's City::
*Employer's State:
*Employer's Zip Code:	(5 digits)
*Employer's Phone Number:
Other Monthly Income:	(example $400.00)
Other Income Source:
Rate your credit:
*Have you filed for Bankruptcy in the last 3 years?
*Are you Over 18:	(If No, apply with a Co-Applicant below)
*Are You a U.S. Citizen:
OPTIONAL - Co-Applicant Information
Relationship to Applicant:
First Name:
Middle Initial:
Last Name:
Mother's Maiden Name:
Social Security Number:	(555-55-5555)
Co-Applicant Birth Date:	(mm/dd/yyyy)
Co-Applicant Email:
Co-Applicant Address 1:
Co-Applicant Address 2:
Co-Applicant City:
Co-Applicant State:
Co-Applicant Zip Code:	(5 digits)
Co-Applicant Time at Current Address:	(years and months)
Co-Applicant Do you:
Monthly Payment:	(example $1,200.00)
Co-Applicant Home Phone:
Co-Applicant Cell Phone:
REQUIRED with Co-Applicant - Employer Information
Co-Applicant Employer:
Co-Applicant Position:
Co-Applicant Gross Monthly Income::	(example $2,500.00)
Co-Applicant Time at Current Employer:	(years and months)
Co-Applicant Employer Address:
Co-Applicant Employer's City:
Co-Applicant Employer State:
Co-Applicant Employer Zip Code:	(5 digits)
Co-Applicant Employer's Phone Number:
Co-Applicant Other Monthly Income:	(example $400.00)
Co-Applicant Other Monthly Income Source:
Co-Applicant Have you filed for Bankruptcy in the last 3 years?
OPTIONAL - Secured Loan
Would you use your home as collateral?
Estimate Property Value:
Estimate Mortgage Balance:
Financial Information
*Card Holder Name:	(exactly as it appears on card)
*Card Type:
*Debit Card:
*CCV:	(3 digits appears on back of card)
*Account Number:
*Expiration Date:	(mm/dd/yyyy)
*Billing Address:
*Billing City:
*Billing State:
*Billing Zip Code:	(5 digits)
Authorization to Release Credit Information and Credit Policies
	By submitting this application, I authorize Medical Finance Partners, LLC, (MFP) (and/or their authorized lenders) to run a credit report and verify the information I have provided. I authorize MFP to charge my Credit Card, Visa, MasterCard or debit card a $29.00 non-refundable professional fee should my loan be declined/denied. In the event that your application is declined/denied, go to www.medicalfinanceparnters.com select annualcreditreport link to get your credit report and call MFP for your free consultation valued at $150. I understand MFP will be acting as a fee based credit-processing agent on my behalf and therefore does not approve deny, set the rate and terms, guarantee loan approvals or discriminate against anyone for any reason. As a part of this search, I fully understand my credit request may be presented to multiple credit issuing companies including (but not limited to) banks, finance companies, credit card issuers, and affiliated partnership programs. For these services, I understand that I will be charged loan processing and closing fees which will be added to my monthly payment, furthermore, while calculated monthly, I understand that the total amount of the fees will be added to my base loan amount requested and become a part of my principle balance or by my signature authorize MFP the right to deduct MFP's processing fee from my Credit Card, Visa, MasterCard or debit card. I understand that I will not be charged the processing fee of $395-$595 unless I accept a loan or the loan amuont(s) delivered meet or exceed my loan request. Fees are calculated and charged as follows: $395.00 for loans up to $4999.00, $495.00 for loans up to $7499.00, $595.00 for loans above $7500.00. I understand MFP will preauthorize my credit card for the processing fees which may include those funds being held until processing is complete. You could be charged and prosecuted for mail or wire fraud if you use the mail or telephone to apply for credit and provide false information. It's a federal crime to make false statements on a loan or credit application. I agree to hold harmless MFP from any and all legal actions that might be taken as a result of a disputed matter with my Service Provider or Vendor.
	I accept the above term and conditions
*I Agree:	Applicant Initials