Bitcoin Loans

Need a quick Bitcoin loan in Canada? Complete the form below, and we’ll convert your funding to Bitcoin.

Want to buy Bitcoin instead? Buy Bitcoin Here.

Purpose of Loan

Borrowing Amount

First Name

Last Name

Email Address

Date of Birth

City

Select a Province

Postal Code

Mobile Phone

Work Phone

Address

Do You Rent or Own Your Home?

How Long Have You Lived Here? (In months)

Rent/Mortgage Payment Amount

Property Value Amount

Property Mortgage Amount

Occupation (Job Title)

Employer Name

Job Title

Monthly Income

How many months have you been employed here?

Do you receive your income by direct deposit?

Pay Frequency

Next Pay Date

Pay Date After the Next

Select Credit Score

Allow credit authorization? (Does not affect your credit score)

Are you presently in a DMP? (Debt Management Proposal)

Are you presently in Bankruptcy?

Are you presently in Consumer Proposal?

How much credit card debt do you have?

How much unsecured debt do you have?

Canadian Status

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