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The following information is requested by the federal government for certain types of loans related to a dwelling in order to monitor the lender's compliance with equal credit opportunity, fair housing, and home mortgage disclosure laws. You are not required to furnish this information, but are encouraged to do so. You may select one or more designations for "Race." The law provides that a lender may not discriminate on the basis of this information, or on whether you choose to furnish it. However, if you choose not to furnish the information and you have made this application in person, under federal regulations the lender is required to note ethnicity, race, and sex on the basis of visual observation or surname. If you do not wish to furnish the information, please check below.
I do not wish to furnish this information
Hispanic or LatinoNot Hispanic or Latino
American Indian or Alaska NativeAsianBlack or African AmericanNative Hawaiian or Other Pacific IslanderWhite
Please enter employment information for the past 2 years.
PurchaseConstruction - PermConstructionNo Cash-Out RefinanceCash-Out RefinanceOther
Primary ResidenceSecond HomeInvestment
Community PropertyJoint TenantsSingle ManSingle WomanMarried ManMarried WomanTenants in CommonTo be decided in escrowUnmarried ManUnmarried WomanOther
SavingsSale of homeGift401k retirement planother