SECURE FINANCE APPLICATION This is a secure page. Information sent through this page is encrypted for your own security. Lender Name (Optional) Sales Rep (Optional) Amount Requested (Optional) Services Requested (Optional) Solar PanelsBattery StorageRoofingHeating/CoolingWindows/Doors BORROWER INFORMATION Full Name (required) Date Of Birth (required) SSN (required) ID Number (required, DL, Passport, etc) ID Issued Date (required) ID Expiry Date (required) Address (required) City (required) State (required) Zip Code (required) Phone (required) Alternate Phone (optional) Your Email (required) Who do you bank with? Employer Occupation Salary Length of Employment Employer Phone # Employer Website If you have a co-applicant please have them also fill in their own application and list their name below Co-applicant name PROPERTY INFORMATION Year Purchased Purchase Price Current Value Mortage Holder Monthly Payment BY CHECKING THIS BOX YOU PROMISE ALL INFORMATION IS TRUE AND COMPLETE. YOU INTEND THE SELLER AND/OR ASSIGNEE TO RELY UPON THESE PROMISES IN DECIDING WHETHER OR NOT TO EXTEND CREDIT TO YOU. YOU AUTHORIZE A FULL INVESTIGATION AND RELEASE OF YOUR CREDIT RECORD AND YOUR EMPLOYMENT HISTORY. YOU ALSO AUTHORIZE US AND/OR THE ASSIGNEE TO RELEASE INFORMATION ABOUT EXPERIENCE. CREDIT REPORT NOTICE: WE MAY REQUEST A CREDIT REPORT FOR ANY LEGITIMATE PURPOSE ASSOCIATED WITH YOUR APPLICATION FOR CREDIT, EXTENDING CREDIT, MODIFYING THE TERMS OF YOUR CREDIT AGREEMENT, OR COLLECTION ON YOUR ACCOUNT. ON YOUR REQUEST, WE WILL INFORM YOU IF SUCH REPORT WAS ORDERED AND WILL GIVE YOU THE NAME AND ADDRESS OF THE CREDIT REPORTING AGENCY THAT FURNISHED THE REPORT.