Lender Addendum
Please complete the addendum below to provide additional information about your business to ACHQ.
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Merchant Information
Business Name
*
DBA
Loan Info
Please answer the questions below
Average Loan Term
*
Max Loan Term
*
Average Loan APR
*
Maximum Loan APR
*
Types of Loans
*
Do you fund Consumers Directly, or is payment made to a dealer/store/vendor?
*
Document Upload
Please upload the documents requested below
Finance, Lender, or Broker License
*
Drop files here or
Select files
Max. file size: 32 MB.
Sample Finance Agreement or Loan Contract
*
Drop files here or
Select files
Max. file size: 32 MB.
3 Month@amp;#039;s Processing Statements (credit card or ACH)
*
Drop files here or
Select files
Max. file size: 32 MB.
Dispute/Compliant Resolution Policy
*
Drop files here or
Select files
Max. file size: 32 MB.
With my Signature below I acknowledge that:
*
That the information submitted is true and accurate
please check above to acknowledge
Typed Name of Signor
*
Date Signed
*
MM slash DD slash YYYY
Please Sign Below
*
Email
This field is for validation purposes and should be left unchanged.
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