I/We have applied for credit from the Lender. As part of the application process,
the Lender and any potential investor or insurer of this loan may verify the information
contained in my/our credit application and in other documents required in connection
with this loan.
I/We authorize you to provide to the Lender and to any potential investor or insurer
of this loan, any and all information and documentation requested. Such information
may include, but is not limited to: employment and income history, bank, money
market and similar account balances; credit history; and copies of income tax returns.
The source of the information may come from, but is not limited to: credit
bureaus; banks and other depository institutions; current and former employers;
federal or state records including State Employment Security Agency (SESA) records;
or other sources as required.
This authorization to access employment and income history from federal or state
records including SESA records, for this transaction continues in effect for one
(1) year unless limited by state law, in which case the authorization continues
in effect for the maximum period, not to exceed one (1) year, allowed by law.
Certification: I/We certify that the information provided in this application
is true and correct as of the date submitted by clicking "Submit Application" below.
I/we acknowledge my/our understanding that any intentional or negligent misrepresentation(s)
of the information contained in this application may result in civil liability and/or
criminal penalties including, but not limited to, fine or imprisonment or both under
the provisions of Title 18, United States Code, Section 1001, et seq. and liability
for monetary damages to the Lender, its agents, successors and assigns, insurers
and any other person who may suffer any loss due to reliance upon any misrepresentations
which I/We have made on this application.