About You

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First Name	MI	Last Name	Date of Birth

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E-mail Address	E-mail Address (Confirm)

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Street Address

City	State	Zip

Your Home Phone #

Cell Phone #

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Fax #

Contact Phone #

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Where we can send a you fax, only if needed.

Where we can contact you right away if there is an issue processing your application.

Social Security #

Social Security # (Confirm)

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About Your Job and References

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Company Name

Company Phone #

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Name of company where you work.

The company's main number.

Your Job Title	Date Hired

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Your Work Number

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Shift Hours

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Your phone number at your company, including your extension.

Ex.: 9 am to 5 pm

Supervisor's Full Name

Supervisor's Phone #

Ext.

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Reference 1 Name

Reference's Phone #

Relation to You

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Reference 2 Name

Reference's Phone #

Relation to You

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Please review the Terms of this agreement:

Choice of Law/No Waiver of Tribal Sovereign Immunity:  This  Agreement and the Note evidencing your loan with us (“Loan”), and all matters related thereto including but not limited to the loan’s validity, enforcement and effect shall be governed by the  Laws, Ordinances and Resolutions of the Guidiville Indian Rancheria (“Tribe”), and the decisions of the Tribal Lending Regulatory Authority and the Tribal Council of the sovereign Tribe, a U.S. Federally-Recognized Indian Tribe, located and operating its lending business within the jurisdiction of the Tribe's Trust Lands.  Under Tribal law, your Loan with us shall be deemed to have been entered into and consummated on the Trust Lands of the Tribe.  For guidance purposes only, the Tribal Lending Program shall note the requirements of certain relevant federal consumer loan laws of the United States.  However, in no event shall any remedies contained in such consumer loan laws be applicable to TLE, its Servicer or the Tribe including any remedies for money damages.  Notwithstanding any limited remedies for consumer borrowers set forth in the Arbitration section of this Agreement below, nothing in this Agreement and the Note shall be construed to be a waiver of the Tribe’s sovereign immunity.   Please click on box if Choice of Law is acknowledged and accepted.


Mandatory Pre- Dispute Resolution:  If you have a complaint about any aspect of your loan with us or any other claims, disputes or controversies that you may believe you have against us, you must write to us and provide us with the details of your complaint in a written Notice of Pre-Arbitration Dispute Resolution (“Notice”).  The Notice must be sent by certified mail to the “Notice Address” set forth below. The Notice must (a) describe the nature and basis of the claim or dispute; and (b) set forth the specific relief sought, which shall be designated as the “Demand”.  If we do not reach an agreement to resolve your Demand within thirty (30) days after the Notice is received, you may commence an arbitration proceeding within ninety (90) days, utilizing the process described below, which shall be the exclusive process to resolve the claim and your Demand.
	Notice Address:
		Tribal Business Ventures*
		c/o Tribal Business Management
		P.O. Box 573
		Talmage, California 95481

*THIS ADDRESS SHOULD ALSO BE USED BY YOU FOR ANY GENERAL CORRESPONDENCE OR BANKRUPTCY NOTICES FROM YOU TO TLE.

Arbitration:  Agreement to Arbitrate Disputes/No Waiver of Sovereign Immunity:
Please read this carefully.  It affects your rights.
To commence the arbitration proceeding, you must send to the Arbitration Address set forth below, by certified mail, a copy of the Notice referenced above with a statement that you have been unable to resolve your claim with us and therefore demand your right to arbitration in accordance with your Consumer Loan Note.
You and we, the Borrower and Lender named above, which includes our respective subsidiaries, affiliates, predecessors in interest, successors and assigns, servicers, agents, directors, officers and employees, agree to arbitrate all claims, disputes or controversies that arise out of or relate to:  (i) your application for the loan, (ii)  the loan and any other loan you previously obtained or later obtained from us, (iii) the Loan Note and Disclosure (the “Note”) that governs your payment or obligations on the loan, (iv) this Agreement to Arbitrate Disputes (the “Arbitration Agreement”), (v)  payment and collection of the loan or loans, (vi) allegations of fraud or misrepresentation; or (vii) any other claims, disputes or controversies that you may believe you have against us, whether such claims, disputes or controversies arise under the common law or pursuant to United States federal, state, local statute, ordinance or regulation.  All issues are for the arbitrator to decide, including the scope of this arbitration clause, but the arbitrator is bound by the terms of this Consumer Loan Note.  This agreement evidences a transaction in interstate commerce.
	Arbitration Address:
		Tribal Lending Regulatory Authority – Arbitration
		P.O. Box 339
		Talmage, California 95481

YOU AGREE THAT YOU MAY BRING CLAIMS AGAINST US ONLY IN YOUR INDIVIDUAL CAPACITY, AND NOT AS A PLAINTIFF OR MEMBER OF ANY PURPORTED CLASS OR REPRESENTATIVE PROCEEDING.
This Arbitration Agreement is an independent, severable agreement and shall survive the closing, funding, repayment and/or default of the loan for which you are applying.
The arbitration shall be governed by and under the arbitration rules and procedures of the Tribe (the “Tribal Arbitration Rules”) in effect at the time the claim is filed.  A current copy of the Tribal Arbitration Rules may be printed off from our Website home page.
You and we agree to the following Tribal Arbitration Rules (the “Rules”):
(1)  The Arbitrator shall be the Tribal Regulatory Agent (“Regulatory Agent”) duly appointed by the Tribal Council to regulate Licensed Lenders under Tribal law.  (2)  There will be no filing fees or charges to you for the cost of the Arbitrator or arbitration, and we shall bear the entire cost of the Arbitrator and arbitration.  (3)  The arbitration shall be conducted with the Arbitrator and the parties, which at your election may either be based solely on the documents submitted by the parties or via a telephone conference call with such documents and with all the parties able to hear each other and participate.  The arbitration shall be concluded within thirty (30) days of your commencement of the arbitration. (4)  All materials and documents to be considered by the Arbitrator shall be provided to the Arbitrator and each party by the other party at least one week before the arbitration hearing. (5)  You and we may each be represented by counsel at our own respective expense.  (6)  All proceedings in the Arbitration, including any documents and information that may be submitted in the Arbitration, and all award decisions by the Arbitrator, shall be kept confidential and private to protect your and our privacy.  (7)  This Arbitration Agreement shall apply no matter by whom or against whom the claim is filed, and you or we may file a counterclaim against each other in the arbitration.  (8)  Discovery involving this arbitration shall be limited to your banking records and your loan documents that are directly related to your claim, which shall be promptly produced upon a written demand in the arbitration. (9)  You may not be awarded any relief that is more than your Demand or your actual damages, whichever is less.  However, the Arbitrator shall award you all of your reasonable attorney’s fees, plus treble damages, if you are awarded an amount equal to or greater than your Demand or your actual damages, whichever is less.  (10)  The Arbitrator may not award any relief in excess of what these Rules provide.  (11)  We may be awarded only the actual amount of any unpaid principal and interest payable to us under your Note with us.  (12)  No amount of our attorney’s fees are reimbursable by you.  (13) The Arbitrator’s decision (“Award”) will consist of a written statement stating the disposition of each claim, and shall be sent within one week after the hearing, or within thirty (30) days of the commencement of the arbitration, whichever date may be later.  There shall be no appeal from the Award and the Award shall be final and binding upon you and us.  (14)  If you fail to reasonably cooperate in the scheduling of any hearing or otherwise in the arbitration, the Arbitrator may deny you any relief, and if we fail to reasonably cooperate in the scheduling of any hearing or otherwise in the arbitration, the Arbitrator may grant you relief in accordance with these Rules.  (15)  Judgment upon any such arbitration award may be entered with the Tribe’s Tribal Council.  To enter judgment, you must send to the Tribal Council Address set forth below, by certified mail, a copy of the Award with a statement that it remains unsatisfied after more than one week.  The Tribal Council shall thereupon order that such award be paid immediately.
	Tribal Council Address:
Tribal Council Chairperson – Arbitration Award
P.O. Box 339
Talmage, California 94501

Agreement Not to Bring, Join or Participate in Class Actions.   By signing below and to induce us to process your application for a loan, you agree that you will not bring, join or participate in any class action as to any claim, dispute or controversy you may have against us (or our agents, servicers, directors, officers and employees) arising in any way from this or any other loan transaction you have had or may have with us.  You agree to the entry of injunctive relief by us to stop such a lawsuit or remove you as a participant in the suit.  You agree to pay the cost we incur, including our court costs and attorney’s fees in seeking such relief.  This agreement not to participate in class actions is not a waiver of any of your rights and remedies to pursue an arbitration claim individually (and not as a class action) in binding arbitration as provided above.  This agreement not to bring, join or participate in class actions is an independent, severable agreement and shall survive the closing, funding, repayment and/or default of the loan for which you are applying.

Please click on the box if individual Arbitration is acknowledged and accepted. 

YOU AGREE THAT WE DO NOT IN ANY MANNER WHATSOEVER WAIVE OUR SOVEREIGNTY OR OUR IMMUNITY FROM SUIT, AND THAT NOTHING IN THIS CONSUMER LOAN AGREEMENT OR THESE RULES SHALL BE CONSTRUED TO WAIVE OUR SOVEREIGNTY OR OUR IMMUNITY FROM SUIT, NOR SHALL ANYTHING BE CONSTRUED AS A CONSENT TO BE SUED EXCEPT AS EXCLUSIVELY PROVIDED BY THE ARBITRATION PROCEDURE IN THIS CONSUMER LOAN AGREEMENT.  AT ALL TIMES, THE TRIBE MAINTAINS ITS SOVEREIGNTY AND ITS IMMUNITY FROM SUIT IN ALL JURISDICTIONS EXCEPT WITHIN THE ARBITRATION PROCESS PROVIDED IN THIS CONSUMER LOAN AGREEMENT, WHICH IS MAINTAINED EXCLUSIVELY WITHIN THE TRIBE.

Once you are approved and funds are deposited there will be a one time processing fee of TEN DOLLARS that will be debited from your account.

There will be an initial one time fee charged of twelve dollars for any ach debit items that are returned. Any ach debits items that are returned there after will be charged thirty dollars.

If your account is in default and you have not made payment arrangements, the company will debit from your account a daily late fee of three dollars until payment arrangements have been made.

Please click here to print the terms of agreement.

If you agree to the terms, choose "I Agree":

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To continue, please click the "Submit My Completed Application" button below.

We will not be able to give you a loan if you are a regular or reserve member of the Army, Navy, Marine Corps, Air Force or Coast Guard, serving on active duty under a call or order that does not specify a period of 30 days or fewer (or a dependent of such member). Warning: It is important to fill out this form accurately. Knowingly making a false statement on a credit application is a crime.

Loans are not available to residents of Pennsylvania (PA), Florida (FL), New York (NY), Colorado (CO), District of Columbia (DC), Illinois (IL), Georgia (GA), Kansas (KS), Delaware (DE), Nebraska (NE), Oregon (OR), West Virginia (WV), Massachusetts (MA), Minnesota (MN), Ohio (OH), Washington (WA), California (CA) and Montana (MT).

About You

About Your Job and References

About Your Pay

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