Fillable AEC Loan Application LocalPowerCompany_ PrimaryApplicantInformation SecondaryApplicantInformation (Appalachian Electric Cooperative)

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AEC Loan Application LocalPowerCompany_ PrimaryApplicantInformation SecondaryApplicantInformation (Appalachian Electric Cooperative)

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AEC Loan Application

Applicationfor:

HVACEquipmentOnly WeatherizationOnly HVACEquipmentandWeatherization No.ofHVACUnits__________

Amountofloanrequested(ifknown):______________________Program________________________________________

Pleasecheckifyouareapplying: SingleApplicant JointApplicant

IFYOUINTENDTOAPPLYFORJOINTCREDIT,PLEASEINITIALHERE:Applicant'sInitials__________Co‐Applicant'sInitials__________

LocalPowerCompany_

_____________________________________________________________________

PrimaryApplicantInformation

FirstName_______________________LastName_______________

SSN#_____________________________DateofBirth_____________

MailingAddress InstallationAddress(checkallthatapply)

StreetAddress_____________________________________________

City_____________________State______________ZIP__________

County___________________________________________________

PrimaryPhone

_____________________________________________

SecondaryPhone___________________________________________

Driver’sLicenseState______Number__________________________

PreviousAddress(iflessthan3yearsatcurrentaddress)

StreetAddress_____________________________________________

City_____________________State______________ZIP__________

InstallationAddress( Sameasaddressabove)

StreetAddress_____________________________________________

City_____________________State______________ZIP__________

County___________________________________________________

SecondaryApplicantInformation

FirstName_______________________LastName_______________

SSN#_____________________________DateofBirth_____________

MailingAddress InstallationAddress(checkallthatapply)

StreetAddress_____________________________________________

City_____________________State______________ZIP__________

County___________________________________________________

PrimaryPhone

_____________________________________________

SecondaryPhone___________________________________________

Driver’sLicenseState______Number__________________________

PreviousAddress(iflessthan3yearsatcurrentaddress)

StreetAddress_____________________________________________

City_____________________State______________ZIP__________

AcknowledgementandSignatures

To help the government fight the funding of terrorism and money laundering activities, Federal law requires financing institutions to obtain, verify, and record information that identifies applicant. All

applicants will be asked to provide name, address, date of birth, and other information and may be asked to provide driver’s license or other identifying documents.

By signing below, applicant and co-applicant, if any (Applicants), understand and agree that: (1) The program financing will involve security arrangements (lien filed on property) which may make it more

difficult to obtain financing for your home; (2) Applicants must provide and maintain satisfactory security arrangements for the requested loan; (3) Applicants reveal and are responsible for any

outstanding AEC loan balances, and the requested loan amount is no more than the maximum amount allowed reduced by any outstanding balances; (4) Providing a social security number is not

required to be considered for a loan, but social security numbers will expedite consideration of this application; and (5) Applicants will be informed if this application is not approved. Applicants certify that

everything stated in this application is correct to the best of their knowledge. Applicants authorize and permit AEC to perform background checks and obtain information about Applicant(s) from credit

reporting sources.

PrimaryApplicant'sSignature

____________________________________________________________Date_________________________

SecondaryApplicant'sSignature

_________________________________________________________Date__________________________

‐‐‐AECUse Only‐‐‐

ContractorName(ifknown)________________________________________________ ________  

ContactName__________________________________________________

ElectricAccount#______________________________ Pre‐QualificationScreening: Approved NotApproved

IDVerified

Type______________________________ExpDate________________________

AEC

AEC Loan Application

‐‐‐AEC useonly‐‐‐

Applicant Pre-Screening

A YES NO Prior-Requirements for Financing

Applicant is a customer of AEC

Applicant owns the home/dwelling

If manufactured home, the land owner is known and willing to co-sign the loan

B YES NO Payment History Screening

Utility Payment History is satisfactory (Based on prior 12-month payment history)

If“No”ischeckedonanyoftheseitems,thentheloanshouldnotbeapprovedbyAEC.

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Completed 18 February 2021

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