America Choice Mortgage

Mortgage Application

General Information


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Financial Information

Employment History

Please list employment history for the past 3 years beyond current employer

Banking Institutions

Government Monitoring

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. The law provides that a Lender may not discriminate either on the basis of this information, or on whether you choose to furnish it. If you furnish the information, please provide both ethnicity and race. For race, you may check more than one designation. If you do not furnish ethnicity, race, or sex, under Federal regulations, this lender is required to note the information on the basis of visual observation and surname if you have made this application in person. If you do not wish to furnish the information, please check the box to the right. (Lender must review the above material to assure that the disclosures satisfy all requirements to which the lender is subject under applicable state law for the particular type of loan applied for.)

Legal Declarations

If you answer yes to any of these questions, please use continuation sheet for explanations.


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Final Acknowledgement

By signing this Credit Analysis Request, I/we give permission to inquire into my/our credit history and use such information to explore potential financing alternatives. I/we understand that this is not a loan commitment as defined by Regulation Z.
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