Employee Financial Hardship Loan Request

Employee Financial Hardship Loan Request — Form Fields

This finance template includes 10 fields. Apply for an internal hardship loan or pay advance with reason, repayment terms, and supporting details. Free to customize and use on ZenBuild.

• Employee Full Name (text, required)
• Employee ID (text, required)
• Work Email Address (email, required)
• Department and Manager Name (text, required)
• Amount Requested ($) (number, required)
• Reason for Request (dropdown selection, required) — options: Medical emergency, Natural disaster, Funeral/bereavement costs, Housing emergency, Other
• Brief Description of Hardship (long text, required)
• Preferred Repayment Schedule (dropdown selection, required) — options: Deduct over 3 payroll periods, Deduct over 6 payroll periods, Deduct over 12 payroll periods, Lump sum next payroll
• Supporting Documentation (optional) (file upload, optional)
• Have You Previously Received a Hardship Advance? (multiple choice, required) — options: Yes, No