Personal Information
Marital Status Single Married Divorced Widowed
Are you a U.S. citizen? Yes No
Current Address
State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Armed Forces Americas Armed Forces Europe Armed Forces Pacific
Subject Property
Purpose of Loan Purchase Construction - Perm Construction No Cash-Out Refi Cash-Out Refi Other
Property Usage Primary Residence Second Home Investment Select 3
State / Province / Region Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Armed Forces Americas Armed Forces Europe Armed Forces Pacific
Monthly Income
Submitting income from alimony, child support, or separate maintenance income is optional if you do not want to use that income for qualification purposes.
Assets
Information for Government Monitoring Purposes
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.
Privacy Policy
Information We Gather and the Parties to Whom We Disclose the Information Click Quick Loan, LLC. (“Business”). In order to process your loan, comply with government regulations, improve our products and services, and better understand your financial needs, Business collects and maintains personal information about our customers and former customers from the following sources: Information we receive from you on applications or other forms; Information about your transactions with us, our affiliates, or others; and Information we receive from consumer reporting agencies. We may disclose the information above within our family of companies (“affiliates”). The affiliates to whom we disclose personal information about our customers and former customers include affiliated insurance companies. We may disclose the information above to our affiliates as follows: We may share the information described above with our affiliates so that we may provide our existing and former customer with valuable product and service offers. We may also share the information we collect with our affiliates who perform administrative and servicing functions, as permitted by law. In addition, we may disclose the information above with non-affiliated third parties who service and process the loans and financial products that we offer to our customers and former customers, as permitted by law.The law allows us to share identifying information and information about our transactions and experiences with you. You may direct us not to share other information that is assembled or used to determine your eligibility for a product or service, such as that shown on consumer credit reports and asset and income information from applications. If you prefer that we not share this other information with our affiliates, you may choose to opt-out (or ask us not to share). To opt-out, simply notify us by calling (866) 677-0242. Your opt-out request will become effective as soon as reasonably practicable after we receive it. How We Maintain the Confidentiality and Security of Your Personal InformationWe maintain physical, electronic, and procedural safeguards that comply with all legal requirements to guard your nonpublic personal information. We restrict our employees’ access to nonpublic personal information about you to those employees who need to know that information to provide products or services to you. We also require third parties to whom we disclose personal information as permitted by law and our affiliates to maintain appropriate procedures to ensure the security and confidentiality of your personal information. Our Commitment to You to Maintain Accurate InformationWe are committed to providing you with superior customer service. We strive to ensure your account information is correct and current. Should you at any time discover that information pertaining to your account is inaccurate or not up-to-date, please contact us at the address or toll-free telephone number shown below:Click Quick Loan, LLC.439 E. Tarpon Avenue, Tarpon Springs, FL 34689 Attn: Legal Dept.(866) 677-0242I/We hereby acknowledge receipt of this two-page Privacy Policy Notice at or prior to the time of our mortgage loan application and understand the provisions contained herein.
Do you accept this privacy policy?* Please select Yes
