Fill out all entries on form and click submit you will recieve email once your application has been successfully submitted:
Tribal ID Number:
First and Last Name:
Maiden Name:
Social Security Number:
Mailing Address:
Phone Number:
Where are you employed: Select your employer HHCDA FNCF Government Gaming
Amount Requested (up to $5,000):
Delivery Method Hold for Pick Up Mail
upon receipt of a loan from the Ho-Chunk Nation, do hereby pledge as collateral any and all future Per-Capita Distributions should this loan or any other prior tribal loans become delinquent. I understand that by signing this Agreement I am giving permission to the Ho-Chunk Nation to withhold any and all amounts due to them. Any amount of the Per-Capita Distribution, which exceeds the balance, will be returned to me.
First, MI, Last Name:
pursuant to lawful action taken by the Finance Committee. In consideration for the sum of this loan made payable to the member the following terms are in force.
1) That applicant hereby agrees to pay to the Nation the sum of loan at the rate of $ 50.00 a week, until said loan is paid in full. There will be no penalties for prepayment.
2) That applicant hereby agrees to pay interest on the loan to the Nation at a simple interest rate of 10%, which will be added to the principal at the time the loan is processed.
3) That in the event that this applicant fails to make payments of $ 50.00 a week, as agreed, the Nation shall have the option of calling all future payments that are due and owing, and the Nation may seek payment of the full amount of the outstanding balance.
4) That in the event that your employment with the Nation has ended, the Nation’s payroll has the authority to withhold from your final paycheck all vacation hours up to $1,000.00 dollars and any amount above minimum wage to be applied to the balance of your tribal loan.
Do you agree with the terms and conditions of this loan?:
Signature:
Choose Date: