|
|
 Skip Nav Skip to Search |
|
APPLICANT LOAN REPORT for MODIFIED TRANSPORTATION Word documentWhat is your disabling condition? What type of modified transportation do you want to purchase? Please describe, must provide make, model, mileage, year and price. Do you have past credit problems (6 months ago or more)? Yes No If yes, describe: Do you have current credit problems (in the last 6 months)? Yes No If yes, describe: What arrangements have you made to pay any past due bills? Do you have medical insurance; if so, who is your insurer? What is your current adaptive method? Do you have any support or assistance in the home, for example: a spouse, family member and or in-home assistance care? How did you find out about this low interest loan program? Other comments, if you would like to explain anything else on this guarantee loan request. APPLICANT LOAN REPORTWhat is your disabling condition? What type of assistive technology do you want to purchase? Please describe. Do you have past credit problems (6 months ago or more)? Yes No If yes, describe: Do you have current credit problems (in the last 6 months)? Yes No If yes, describe: What arrangements have you made to pay any past due bills? Do you have medical insurance; if so, who is your insurer? What is your current adaptive method? Do you have any support or assistance in the home, for example: a spouse, family member and or in-home assistance care? How did you find out about this low interest loan program? Other comments, if you would like to explain anything else on this guarantee loan request. APPLICANT LOAN REPORT for MODIFIED TRANSPORTATIONWhat is your disabling condition? What type of modified transportation do you want to purchase? Please describe, must provide make, model, mileage, year and price. Do you have past credit problems (6 months ago or more)? Yes No If yes, describe: Do you have current credit problems (in the last 6 months)? Yes No If yes, describe: What arrangements have you made to pay any past due bills? Do you have medical insurance; if so, who is your insurer? What is your current adaptive method? Do you have any support or assistance in the home, for example: a spouse, family member and or in-home assistance care? How did you find out about this low interest loan program? Other comments, if you would like to explain anything else on this guarantee loan request. APPLICANT LOAN REPORTWhat is your disabling condition? What type of assistive technology do you want to purchase? Please describe. Do you have past credit problems (6 months ago or more)? Yes No If yes, describe: Do you have current credit problems (in the last 6 months)? Yes No If yes, describe: What arrangements have you made to pay any past due bills? Do you have medical insurance; if so, who is your insurer? What is your current adaptive method? Do you have any support or assistance in the home, for example: a spouse, family member and or in-home assistance care? How did you find out about this low interest loan program? Other comments, if you would like to explain anything else on this guarantee loan request. |
||
| Copyright ©
State of Oklahoma OK.gov Help Desk | OK.gov Policies | About Oklahoma's Web Portal | Feedback |
|||