Paramount Capital

Pacific Pools and Patios
Riverside, CA

FIRST APPLICANT:

* First Name:

Middle Initial:

* Last Name:

* Social Security #:

* Birthday (mm/dd/yy):

* Application Type:

* Marriage Status:

* Phone:

* Email Address:

* Driver's License Number:

* Driver's License State:

* Driver's License Expiration:

Housing Information

* Present Address:

(Number, Street, Apt. P.O. Box)

* City:

* County:

* State:

* Zip:

* How Long?

years months

Previous Address:
(If less than 5 years)

(Number, Street, Apt. P.O. Box)

City:

County:

State:

Zip:

How Long?

years months

Employment Information

* Employer:

* How Long?

years months

* Employer Phone:

* Position:

* Gross Monthly Income:

Previous Employer:
(If less than 2 years @ current)

How Long?

years months

Additional Income Source:

Gross Additional Income:
(monthly)

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 on this information , or on whether you choose to furnish it. However, if you choose not to furnish this information, under federal regulations,, the lender is required to note ethnicity and sex on the basis of visual observation or surname. If you do not which to furnish this information please select that option.

Ethnicity

Race or National Origin:

Sex:

SECOND APPLICANT:

First Name:

Middle Initial:

Last Name:

Social Security #:

Birthday (mm/dd/yy):

Daytime Phone:

Email Address:

Driver's License Number:

Driver's License State:

Driver's License Expiration:

Second Applicant Employment Information

Employer:

How Long?

years months

Employer Phone:

Position:

Gross Monthly Income:

Previous Employer:
(If less than 2 years @ current)

How Long?

years months

Additional Income Source:

Gross Additional Income:
(monthly)

Ethnicity

Race or National Origin:

Sex:

PROPERTY TO BE IMPROVED:

* Current Home Value:

* Purchase Date
(ex. mm/dd/yy):

* Purchase Price:

* First Lender:

* Balance:

* Monthly Payment:

Second Lender (if any):

Second Balance:

Second Monthly Payment:

Last Appraisal Amount:

Last Refinance Date:
(if applicable)

* County:

Other Real Estate Owned:

Do you own additional real estate?

Address:

Banking Reference:

Name

Average Balance

Checking Account

Savings Account

Other Assets
(such as 401K, 403B, CD, IRA, Money Market, Brokerage Accts)

Asset Name

Average Balance

WE ARE REQUESTING FUNDS FOR: (select one)


	Swimming Pool		Debt Consolidation
	Other Home Improvements		Cash Out

* Pool Builder Name:

* Contract Price:

* Down Payment:

* Amount Requested:

Term:

months

Defer Payment:

***By electronically signing below, the applicant(s) state that the information provided on this loan application is true and correct. The applicant(s) authorizes Paramount and any Lender as assigned, to obtain my/our credit information and to verify employment and income. I/we consent and authorize information regarding this loan transaction to be communicated between Paramount and any Lender as assigned.

Applicant Sign Name
CoAplicant Sign Name

I certify that I have read the information below.

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before clicking Submit Form.

• I consent to receive the information, follow-up communications, and disclosures related to this credit application electronically.
• My consent is limited to the information and disclosures related to this application only and none other.
• I can withdraw my consent at any time during the application process, as well as before I click the "SUBMIT" button, by clicking on my browser's "BACK" button.
• I understand that my application cannot be processed electronically if I withdraw my consent.
• I understand that I may only request a PreApproval credit application once every 30 days. (Please note that each time you request a PreApproval credit application, a notice will be placed on your credit report.)
• In order to successfully transmit and receive the information and disclosures related to this credit application, I understand I must have: an active Internet connection; a browser capable of sending and receiving secure information; and the ability to print pages from this Web site for my records.
• A consumer report (credit report) may be requested in connection with this credit application. Upon request, you will be informed whether or not a consumer report was requested, and if a consumer report was requested, you will also be informed of the name and address of the consumer reporting agency that furnished the consumer report. If your credit request is granted, subsequent consumer reports may be obtained in connection with any updates, extension, or renewal of credit, or collection of the account.