1Preliminary Information

2Borrower Information

3Business Information

4Uploads

5Acknowledgements

General Applicant Information

Are you the primary applicant or a co-borrower?

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Section 1: Borrower Information

This section asks about your personal information and your income from employment and other sources, such as retirement, that you want considered to qualify for this loan.

Name

First

Middle

Last

SSN

Birth Date

Marital Status

Unmarried: Single, Divorced, Widowed, Civil Union, Domestic Partnership, Registered Reciprocal Beneficiary Relationship

Citizenship

Drivers License (DL) #

DL Issue Date

DL Issue State

Alternate Names

List any names by which you are known or any names under which credit was previously received (First, Middle, Last, Suffix).

Number of Dependents

Ages of Dependents

Cell Phone

Home Phone

Work Phone

Work Phone Extension

Preferred Method of Contact

Current (Home) Physical Address

Street Address with Unit #

City

State

Zip / Postal Code

Home County

How long at current home address?

Enter the number of years and months respectively you have lived at this address.

Years

Enter 0 if none.

Months

Enter 0 if none.

Housing

Is Mailing Address same as Home Address?

Employment and Income

Current Employment Income

Currently Employed

Multiple Employers

Employer or Business Name

Employer's Email

Employer's Contact

Employer's Phone

Employer's Street Address with Unit #

Employer's City

Employer's State

Employer's Zip / Postal Code

Employer's County

Salary Type

Employment Start Date

How long in this line of work?

Years

Enter 0 if none.

Months

Enter 0 if none.

Gross Monthly Income

Total income generated by the business each month, before taxes and other deductions are taken out.

Personal Financial Information – Monthly Financials

Instructions:

Report only verifiable income.
The income reported must be Gross Income.
Spouse’s income only if applicable.
If not applicable, enter 0 for dollars or N/A for text fields.

Household Income (Monthly)

Take Home from Business / Employment

If not applicable, enter 0.

Spouse's Income (If Applicable)

If not applicable, enter 0.

Child Support / Alimony Income

If not applicable, enter 0.

Other Income

If not applicable, enter 0.

Personal Household Expense & Debt Payments (Monthly)

Child Support / Alimony

If not applicable, enter 0.

Credit Card Payments

If not applicable, enter 0.

Education and Childcare

If not applicable, enter 0.

Food and Clothing

If not applicable, enter 0.

Healthcare Expenses

If not applicable, enter 0.

Home Rent / Mortgage & Utilities

If not applicable, enter 0.

Insurance, Gasoline, and Vehicle Payments

If not applicable, enter 0.

Other Household Expenses & Debt Payments

If not applicable, enter 0.

If applicable, explain any derogatory credit information

Explain any issues that you have on your credit report and how you are getting them resolved.

Demographics

The purpose of collecting this information is to help ensure that all applicants are treated fairly and that the needs of communities and neighborhoods are being fulfilled.

Federal law requires that we ask applicants for their demographic information (Gender and race) in order to monitor our compliance with equal opportunity.
You are not required to provide this information but are encouraged to do so. If you do not wish to provide some or all of this information, please select from the below.

The law provides that we may not discriminate on the basis of this information, or on whether you choose to provide it. Federal regulations require us to note your ethnicity, sex, and race on the basis of visual observation or surname. The law also provides that we may not discriminate on the basis of age or marital status information you provide in this application.

Gender

Race

Hispanic Origin?

Minority Owned or Controlled?

Is your business…

Women Owned or Controlled?

Low income Owned or Controlled?

Additional Demographic Information

LITP (Low-Income Targeted Population) End User

If the business that your loan is for hires a third party and the majority of the third party are considered low-income then select “Yes” for LITP End Users.

IA (Investment Area) End User

If the business that your loan is for hires a third party and the majority of the third party live in investment areas as defined by the CDFI Fund, then select “Yes” for IA End Users.

Other Targeted Populations

OTP (Other Targeted Population) End User

If the business that your loan is for hires a third party and the majority of the third party belongs to an “other target populations”, then select the proper values from the list.

Declarations

This section asks you specific questions about the property, your funding, and your past financial history.

Are you a co-signer or guarantor on any debt or loan that is not disclosed on this application?

Are there any outstanding judgements against you?

Are you currently delinquent or in default on a Federal debt?

Are you a party to a lawsuit in which you potentially have any personal financial liability?

Have you conveyed title to any property in lieu of foreclosure in the past 7 years?

Within the past 7 years, have you completed a pre-foreclosure sale or short sale, whereby the property was sold to a third party and the Lender agreed to accept less than the outstanding mortgage balance due?

Have you declared bankruptcy within the past 7 years?

Third Party Designee

Did someone help you fill out this application?

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Section 3: Uploads

All required documents are to be uploaded when completing the loan application. Additional documentation may be requested as needed.