UENME credit request

complete this form to request credit

Name

First Name

Last Name

UenMe Username

Email Address

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

Total Amount Requested

Daily credit requested (In USD $)

$

Reason For Credit Hold

Please tell us why you were put on credit hold

UenMe, LLC
2118 Wilshire Blvd #275
Santa Monica, CA 90403
310.906.0717
support@uenme.co