Loan Gemach – Flatbush Community Fund

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Please fill out this digital form. Once you complete the form you will be emailed a copy. You must then fill in the blank spaces. You and the co-makers must sign the document in the presence of a notary. Please print out this PDF copy. You must fill in the blanks with your information. Then sign and notarize the document with the co-makers. Email notarized form to yweinberg@fcfund.org and a Committee member will be in touch with you.

We, the undersigned, do hereby agree, jointly and severally, to pay on demand by the FCF Gemach the sum of $________________. The Gemach may request payment in full of the entire balance at any time from any one of the undersigned co-makers.
I have read the above and understand my responsibility: Co-Maker (1) Initials ______ Co-Maker (2) Initials ______
County of __________, State of NEW YORK, this day of __________ 20_______

We, the undersigned, do hereby agree, jointly and severally, to pay on demand by the FCF Gemach the sum of $________________. The Gemach may request payment in full of the entire balance at any time from any one of the undersigned co-makers.
 
I have read the above and understand my responsibility: 

Co-Maker (1) Initials ______ Co-Maker (2) Initials ______


County of __________, State of NEW YORK, this day of __________ 20_______

The undersigned are liable for all Bais Din, Legal and Court costs. 2) A copy of a license for the borrower and co-makers is necessary. 3) A $25.00 service charge will be charged for all returned checks. *”Jointly and Severally” means that each of you has the duty of fully performing the obligations set forth herein and that the FCF Gemach, in its sole and absolute discretion, has the right to collect the entire balance owed hereunder.

The Makers of this note (both Borrower and Co-Makers) do hereby waive demand, notice of demand, protest, notice of protest, and notice of nonpayment, and any and all other notices, whatsoever, kind or nature required by the (laws of the) State of New York. The Makers of this note hereby certify that all information given below is true. On demand for value received, we, the undersigned, do hereby JOINTLY AND SEVERALLY* promise to pay to the order of:

Borrower First Name*

Borrower Middle Name

Borrower Last Name*

Borrower Address*

Street Address City State / Province / Region ZIP / Postal Code

Borrower Home Phone*

Borrower Cell Phone*

Borrower Email*

Business Name*

Business Address*

Street Address City State / Province / Region ZIP / Postal Code

Business Phone*

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Spoke to on*

Co-Makers

Co-Maker (1) Name*

First Last

Co-Maker (1) Address*

Street Address City State / Province / Region ZIP / Postal Code

Co-Maker (1) Home Phone*

Co-Maker (1) Cell Phone*

Co-Maker (1) Email*

Co-Maker (1) Name of Business*

Co-Maker (1) Business Address*

Street Address City State / Province / Region ZIP / Postal Code

Co-maker (1) Business Phone*

Ext

Click here if you are related to the applicant

How long do you know the applicant?*

Spoke to on*

Co-Maker (2) Name*

First Last

Co-Maker (2) Address*

Street Address City State / Province / Region ZIP / Postal Code

Co-Maker (2) Home Phone*

Co-Maker (2) Cell Phone*

Co-Maker (2) Email*

Co-Maker (2) Name of Business*

Co-Maker (2) Business Address*

Street Address City State / Province / Region ZIP / Postal Code

Co-maker (2) Business Phone*

ext

Click here if you are related to the applicant

How long do you know the applicant?*

Spoke to on*

By signing below, you represent that all information given in this is true and complete. Credit Reports and Verification: By signing below, you authorize us to obtain a credit report. If you ask, we will tell you if a report has been obtained and the address furnishing the report. You also authorize anyone named in this application or any credit obtain regarding you to verify any information given in this application or on the credit.

Sign this with the co-makers in the presence of a notary.

Signatures

Applicant Signature _________________________________________
 
Co-Maker #1 Signature _________________________________________
 
Co-Maker #1 Signature _________________________________________