Loan Eligibility

You’re on your way to financial health! Please read the following to see if you meet our basic requirements:

	Yes	No
I owe past-due child support that is mandated by a court.
I have a past-due mortgage. (If you rent, respond “No”)
I am actively undergoing bankruptcy, or seeking to file for bankruptcy.
I have an active source of income right now.
I currently live in one of the following qualifying states and can provide proof of address: - Rhode Island - Florida - Delaware - Massachusetts - Illinois - Texas - Colorado - Connecticut - New Jersey - Georgia
I have a bank account or a prepaid card showing activity for the last 90 days and can provide statements to show it.

By checking this box, I acknowledge that I have read the above statements and assert them to be true.

First Name:

Last Name:

Phone:

*Please refrain from using an email that has been previously used by someone else in your household that has applied for a loan with Capital Good Fund.

Referral Partner Account ID