Loan Application

First Name

Last Name

Date of Birth

Applicant's social security number

Street Address

City

Zip Code

Do you rent or own?

Rent

Own

Other

How much do you pay for housing?

Phone

Employer

Job Position or Title

Time on Job

Take Home Each Pay Period

Amount of Other Income

Source of Other Income

Desired Loan Amount

What will this loan be used for?

How did you hear about us?

Will you be applying for this loan with a co-applicant?

Yes

Co-Applicant's First Name

Co-Applicant's Last Name

Co-Applicant Date of Birth

Co-Applicant's Social Security Number

Co-Applicant's Street Address

City

Zip Code

Do you rent or own?

Rent

Own

How much do you pay per month?

Co-Applicant's Phone

Co-Applicant's Email

Co-Applicant's Employer

Co-Applicant's Job Position or Title

Time on Job

Take Home Each Pay Period

Amount of Other Income

Source of Other Income

CLICK IF YOU AGREE TO THE FOLLOWING STATEMENT: If you submit an application, Eastside Credit will obtain your credit report. By submitting this application, you authorize Eastside Credit to make whatever credit inquiries that we deem necessary in connection with this credit application or in the course of the review, collection, refinancing or consolidation of any credit extended in reliance on this application. You authorize and instruct any person or consumer credit reporting agency to compile and furnish to Eastside Credit any and all information related to your creditworthiness or your transactions and experiences. Such information and any information provided by you in this application shall remain Eastside Credits' property whether or not credit is extended. All loans are subject to Eastside Credits' normal credit criteria.

CLICK IF YOU AGREE TO THE FOLLOWING STATEMENT: I am the individual(s) on the loan application.

Your application was submitted and a representative will contact you on the phone number provided.

EASTSIDE

CREDIT CORP.

Loan Application

Contact

Phone: 985-655-5626
Fax: 985-655-5627

756 Grand Caillou Rd.

Houma, LA 70363

Hours

Monday - Thursday - 8:30 a.m. - 5 p.m.

Friday - 8:30 a.m. - 5:30 p.m.

Saturday - By appointment only

Sunday - Closed

© 2026. All rights reserved.
Made by Make Waves Marketing.

EASTSIDE

CREDIT CORP.

Loan Application

Contact

Phone: 985-655-5626 Fax: 985-655-5627

756 Grand Caillou Rd.

Houma, LA 70363

Hours

Monday - Thursday - 8:30 a.m. - 5 p.m.

Friday - 8:30 a.m. - 5:30 p.m.

Saturday - By appointment only

Sunday - Closed

© 2026. All rights reserved. Made by Make Waves Marketing.

Phone: 985-655-5626
Fax: 985-655-5627

© 2026. All rights reserved.
Made by Make Waves Marketing.