This is not a contract for a loan nor does it lock you into any commitment with a contractor. This is an application that will allow us to proceed with your request for a loan to finance your improvement(s). This will include reviewing your credit history. 
   

                                            
Please complete   your application.   information then required*
Requests for loans greater than $4,000 require proof of income (such as recent pay stub, or if self-employed, a copy of your previous year's federal tax return).  Only residential work that has not been started is eligible for financing.
 
SECTION A - INDIVIDUAL APPLICANT INFORMATION
Mr/Mrs/Ms Last Name* First Name* MI Jr/Sr/I/II    
Birth Date*  
Home Phone*
Social Security Number*  
Marital Status (only for residents of: AZ, CA, ID, LA, NV, NM, TX, WA, WI) (single, divorced, widowed)  
Installation Address* Unit #   (where home improvements are to be made)
City* State* Zip*      
Do You Currenlty*      
Yrs at Current Address*  
Do or will you own and reside at the above installation address?*  
Dwelling Type*   (Multi (3 units +) do not qualify)
Mo. Mortgage Payment (including taxes) $  
# People living in household*     
Current Address (if different than the above Installation Address)
   
City State Zip
City State Zip
Mailing Address (if different than the above Current Address)
City* State* Zip*      
Years Employed?*    
Employer's Address*  
Employer Name / Company*  
Years Self-Employed?  
Are you Self-Employed?*  
Employed*  
Monthly Gross Salary* $  
Position or Title
Ext
Business Phone*  
Monthly Gross Salary $
Sources of Other Income
Employment Occupation Number*    
Employement Category Number*    
Alimony, child support, separate maintenance received under: Alimony, child support, or separate maintenance income need not be revealed if you do not wish to have it considered as a basis for repaying this obligation.
 
 
SECTION B - JOINT APPLICANT
Complete only for joint credit (If Joint Applicant is a Co-Borrower/Spouse then they must own and occupy
the home at the above installation address.)
Mr/Mrs/Ms Last Name* First Name* MI Jr/Sr/I/II       
Birth Date*  
Home Phone
Social Security Number*  
Marital Status* (only for residents of: AZ, CA, ID, LA, NV, NM, TX, WA, WI) (single, divorced, widowed)  
Current Address Unit # (if different than the above Installation Address)
City State Zip
Do You Currenlty*      
Yrs at Current Address*  
Do or will you own and reside at the above installation address?*  
              
City* State* Zip*      
Years Employed?*
Employer's Address*  
Employer Name / Company*  
Years Self-Employed?*  
Are you Self-Employed?*  
Employed*  
Monthly Gross Salary* $  
Position or Title
Ext
Business Phone*  
Monthly Gross Salary $
Sources of Other Income
Employment Occupation Number    
Employement Category Number    
Alimony, child support, separate maintenance received under: Alimony, child support, or separate maintenance income need not be revealed if you do not wish to have it considered as a basis for repaying this obligation.
 
SECTION C - Utility Information
 
Electric Utility Co.*  
Gas Utility Co.*  
Water Heating Fuel Type*    
Space Heating Fuel Type*        
                             
SECTION D - MEASURES INSTALLATION INFORMATION
 
Measure(s) To Be Installed    
Efficiency Level
Contractor Doing the Work (name/address)    
Total Cost           $    
                              
 
 
 
   
      $    
 
 
 
 
   
 
      $    
* include any associated costs such as venting, wiring or other electrical work, warranties, etc.  
TOTAL COST:  
  $
SECTION E - LOAN TERM DESIRED
 
Select Desired Loan Term:*  
                                                                         
SECTION F - ASSET AND DEBT INFORMATION
(If Section B has been completed, include information about both the Applicant and Joint Applicant)
 
               Total Assets (checking balance + savings balance + house + automobile + other assets): $
                                                                                                                              ASSET TOTAL OUTSTANDING DEBTS (Attach Additional Sheet if needed)
Creditor
Account Number
Name in which the account is carried
Monthly Payments
Current Value (Balance)
Mortgage
Automobile(s)
To whom?  
Are you obligated to make Alimony, support or Maintenance payments?*     
Are you a co-maker, endorser, or guarantor on any loan or contract?*     
           
           
Are there any unsatisfied judgements against you?*     
Have you declared bankruptcy in the last 7 years?*     
(including taxes) $
$
$
$
If yes, to whom (Name/Address)?  
Amount per Month $  
Amount per Month $  
Total Amount Owed $  
Year  
If yes, for whom?  
If yes, to whom owed?  
If yes, what city/state?  
           
    $         
            $
                                  If you would like an email response to your credit application, please provide your email address: Email: Re-Type Email:        
                    Will there be a co-borrower?