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MLA - Request for Borrower's Information w/o Social
Item #11-5570

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Military Lending Act
REQUEST FOR BORROWER'S INFORMATION
Without Social Security Number Request
#11-5570**

Are you only asking Active Duty status and NOT requesting Social Security Numbers from non-military Borrowers and you are NOT checking your borrowers against the DoD's database (non-safe harbor)?
This form has been designed to document the borrower's Military Status and require the borrower to sign to their statements.  

** This Request for Borrower's Information form does not in itself afford you any specific legal protection and DOES NOT constitute compliance with the Military Lending Act's Safe Harbor provisions.

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$67.00
Quantity Price
10 Pads $67.00
20 Pads $90.00
30 Pads $113.00
40 Pads $136.00
50 Pads $159.00
60 Pads $182.00
70 Pads $205.00
80 Pads $228.00
90 Pads $251.00
100 Pads $274.00