Fillable - SHF Loan Application V10/06/2020

Fill Online, Printable, Fillable, Blank - SHF Loan Application V10/06/2020 Form

Use Fill to complete blank online OTHERS pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

- SHF Loan Application V10/06/2020

On average this form takes 124 minutes to complete

The - SHF Loan Application V10/06/2020 form is 8 pages long and contains:

  • 0 signatures
  • 135 check-boxes
  • 432 other fields

Country of origin: OTHERS
File type: PDF

BROWSE OTHERS FORMS

Related forms
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
SHF Loan Application (11242020) Page 1 of 8
I. PERSONAL OR BORROWING ENTITY INFORMATION
Complete this section for all guarantors and spouse or non-spouse, if applicable. (Attach additional sheets if needed.)
Additional guarantors must complete sections I, V - XI
Borrower is an: ¨ Individual(s) ¨ Entity
Borrowing entity is a: ¨ Corporation (C Corp) ¨ LLC ¨ LP/LLP ¨ S Corp ¨ Other:
Borrowing Entity Name:
Date Formed:
Tax ID:
Any individual who owns 25% or more of the borrowing entity is required to be a guarantor of the loan.
Please list ALL additional owners below or attach organization chart.
Name
Ownership
On Title
Is the structure of the entity changing as part of the
loan transaction?
¨
Yes
¨
No
%
¨ Yes ¨ No
If yes, please describe:
%
¨ Yes ¨ No
%
¨ Yes ¨ No
%
¨ Yes ¨ No
Co-Borrower Name:
Date of Birth:
Social Security #:
Date of Birth:
¨ Married ¨ Single ¨ Divorced
Marital Status:
¨ Married ¨ Single ¨ Divorced
Address 1:
Address 1:
Address 2:
Address 2:
City:
State:
Zip:
City:
State:
Zip:
Phone Number:
Phone Number:
Email Address:
Email Address:
II. LOAN REQUEST
Commercial Mortgage Type Applied For: ¨ Investor ¨ Owner-Occupied
Loan Purpose: ¨ Purchase ¨ Refinance ¨ Cash-out Refinance
Amortization: ¨ 15 Years ¨ 25 Years ¨ 30 Years
Requested Loan Amount:
Requested Interest Rate %:
_______
Loan Program ¨ 5 Year ¨ 30 Year Fixed
Prepayment Type: ¨ 5% for 3 Years ¨ 5% for 5 Years ¨ Declining 5%, 4%, 3%, 2%, 1%
If a Purchase: If a Refinance: Subject Property Cash Flow:
Purchase Contract Expires: Original Purchase Date: Actual Rents in Place (annualized): $
Purchase Price: $ Original Purchase Price: $ Less Actual Expenses (annualized): $
Amount of Down Payment: $ Cost of Improvements Made*: $ Equals Net Op. Income (annualized): $
Current Lender: Gross Annual Rent of Largest Tenant: $
Interest Rate %:
Annual Property & Liability
Insurance Premium: $
Monthly Payment: $ Annual Property Taxes: $
Pay-Off Mortgage 1: $
(*Please do not include mortgage payment or
depreciation as a part of the Actual Expenses above.)
Pay-Off Mortgage 2: $
Pay-Off Outstanding
Taxes/Others: $
Cash Out: $
Cash Out Description:
Is the property subject to any additional liens, encumbrances or restrictions? ¨ Yes ¨ No
If yes, please explain:
Commercial Loan Application
0
SHF Loan Application 11242020
Page 2
of 8
III. SUBJECT PROPERTY INFORMATION
Subject Property Address:
City:
State:
Zip:
Year Built:
Description of Subject Property (attach description if necessary):
Commercial Property Type:
¨ Multifamily
¨ Mobile Home Parks
¨ Mixed Use (>50% Residential) ¨ Warehouse
¨ Mixed Use (<50% Residential)
¨ Office
¨ Other
¨ Automotive ¨ Self Storage
Light Industrial
Retail
Does the property have? ¨ Underground or above ground storage tanks ¨ Automotive repair uses ¨ Ongoing environmental remediation
¨ Hazardous material handling/Licensing ¨ On-si
te dry cleaner ¨ A prior Phase 1 report available ¨ N/A
Estimated Value of Real Estate: $
Source of Value Estimate:
¨ Appraisal ¨ Estimate ¨ Sales Price (if purchase)
Owner Occupied: ¨ Yes ¨ No
Owner Occupancy %:
Yrs. of Investor Experience:
Number of Buildings:
Number of Units:
Building Sq. Footage:
Number of Units Occupied:
Land Sq. Footage:
IV. BUSINESS INFORMATION
Please complete if you are Self-Employed or the Borrower is a Business Entity.
Business Name:
Address:
City: State: Zip:
Years as Business Owner:
Will this business occupy the subject property? ¨ Yes ¨ No
Type of Business: ¨ Corporation (C Corp) ¨ LLC ¨ LP/LLP ¨ S Corp ¨ Other
YTD Business Income
Tax Year 20 ____
Business Income
a. Annual Revenues:
$
a. Annual Revenues:
$
b. Annual Expenses:
(Exclude depreciation)
$
b. Annual Expenses:
(Exclude depreciation)
$
Net Operating Income (A-B)
$
Net Operating Income (A-B)
$
V. EMPLOYMENT INFORMATION
Self Employed:
¨ Yes ¨ No
Self Employed:
¨ Yes ¨ No
Years on the Job:
Years on the Job:
Net ANNUAL Income:
Borrower
Co-Borrower 2
Total Income:
$
$
VI. ANNUAL PERSONAL INCOME AND MONTHLY LIABILITIES
Total MONTHLY Liabilities List all personal and business liabilities
(Example: car payments, equipment leases, and housing expense)
$
VII. ASSETS AND LIABILITIES
Assets Liabilities
Total Assets:
$
Total Liabilities: $
$ Total Cash Available:
(Savings and Checking)
Net Worth: $
$
Total Cash Available:
(Savings and Checking)
Net Worth:
$
0
0
0
SHF Loan Application 11242020
Page 3 of 8
$ $
$ $
$ $
$ $
$ $
$ $
$ $
$ $
$ $
If you answer “Yes” to any questions A through H, please provide a separate explanation. Borrower Co-Borrower
A. Are there any outstanding judgments against you? ¨ Yes ¨ No ¨ Yes ¨ No
B. Have you declared bankruptcy within
the last 4 years?
¨ Yes ¨ No ¨ Yes ¨ No
C. Have you had property foreclosed
upon or given title in lieu thereof in the last 4 years?
¨ Yes ¨ No ¨ Yes ¨ No
D. Are you party to a
lawsuit?
¨ Yes ¨ No ¨ Yes ¨ No
E. Have you directly or indirectly been
obligated on any loan which resulted in foreclosure, transfer of title
in lieu of foreclosure or judgment in the last 4 years?
¨ Yes ¨ No
¨ Yes ¨ No
F. Are you presently delinquent or in
default on any Federal debt or any other loan, mortgage, financial
obligation or loan guarantee?
¨ Yes ¨ No
¨ Yes ¨ No
G. Are you presently in forbearance on any Federal debt or any other loan, mortgage, financial
¨ Yes ¨ No
¨ Yes ¨ No
H. Are you presently in a loan modification plan or have been in a loan modification plan in the
¨ Yes ¨ No
¨ Yes ¨ No
K. Have you been convicted of a
felony within the past 10 years?
¨ Yes ¨ No
¨ Yes ¨ No
L. Are you a U.S. citizen? ¨ Yes ¨ No
¨ Yes ¨ No
M. Are you a permanent resident alien? ¨ Yes ¨ No
¨ Yes ¨ No
If you answered no to questions L and M, please provide visa status:
$ $
$ $
$ $
$ $
$ $
$ $
$ $
$ $
$ $
$ $
$ $
$ $
$ $
$ $
$ $
$ $
$ $
$ $
$ $
$ $
$ $
$ $
$ $
$ $
$ $
$ $
$ $
$ $
$ $
$ $
$ $
$ $
$ $
$ $
$ $
$ $
$ $
$ $
$ $
$ $
$ $
$ $
$ $
$ $
$ $
SCHEDULE OF REAL ESTATE OWNED
Property Address
(enter S if sold, PS if pending sale or R
if rental being held for income)
Year
Acquired
Property
Type
P
r
esent
M
arket Value
Amount of
Mortgages
& Liens
Gross Rental
Inc
ome
M
ortgage
P
ayments
Insurance, Payments,
Tax
es & Misc.
Net Rental
Income
I. Are you obligated to pay
alimony, child support or separate maintenance?
¨ Yes ¨ No
¨ Yes ¨ No
J. If applicable, do you intend to occupy the property as your primary housing residence?
¨ Yes ¨ No
¨ Yes ¨ No
obligation, bond or loan guarantee?
previous 24 months?
VIII. PERSONAL DECLARATIONS
0
0
0
0
0
0
0
0
0
0
0
0
0
0
SHF Loan Application 11242020 Page 4 of 8
IX. BUSINESS DECLARATIONS
Please select N/A if you are closing as an individual and your business is not going to occupy the subject property.
Neither my business, nor any principal of my business has declared bankruptcy in the last 4 years. ¨ True ¨ False ¨ N/A
Neither my business, nor any principle of my business is a party to any lawsuit. ¨ True ¨ False ¨ N/A
My business has never defaulted on any Federal debt including SBA loans. ¨ True ¨ False ¨ N/A
No principle of my business has had a property foreclosed within the past 4 years. ¨ True ¨ False ¨ N/A
The business has neither been denied a license, certification or ability to conduct business nor been suspended or
administratively limited to its ability to conduct business.
¨ True ¨ False ¨ N/A
Please explain any declaration with “false” response
or provide documentation:
X. GENERAL#AUTHORIZATION
I HEREBY AUTHORIZE SILVER HILL FUNDING, LLC, AND ITS SUCCESSORS AND/OR ASSIGNS AS THEIR INTEREST MAY APPEAR, TO VERIFY ANY AND
ALL INFORMATION PROVIDED OR REQUESTED WITH THIS APPLICATION, INCLUDING BUT NOT LIMITED TO MY PAST AND PRESENT EMPLOYMENT,
EARNING RECORDS, BANK ACCOUNTS, STOCK HOLDINGS AND ANY OTHER ASSET BALANCES NEEDED TO PROCESS MY LOAN APPLICATION.
I UNDERSTAND THAT FALSE INFORMATION AND STATEMENTS MAY RESULT IN POSSIBLE PROSECUTION UNDER FEDERAL AND STATE LAWS.
FURTHER, I UNDERSTAND THAT MY INFORMATION WILL BE SCRUBBED AGAINST THE OFAC, SDN LISTS, EXCLUSIONARY AND OTHER LISTS TO
CONFIRM COMPLIANCE WITH THE US PATRIOT ACT, COUNTER-TERRORISM REGULATIONS AND BSA/AML REGULATIONS.
I CERTIFY BY SIGNING BELOW THAT THIS IS NOT AN APPROVAL OR COMMITMENT TO LEND AND THAT I MAY BY DENIED AT ANY TIME DURING THE
PROCESS FOR REASONS INCLUDING BUT NOT LIMITED TO CREDIT WORTHINESS SUCH AS; COLLATERAL ISSUES, BUSINESS PRACTICES OR
UNSTABLE GOVERNMENT/POLITICAL CLIMATE WITHIN A COUNTRY.
Applicant
I AUTHORIZE SILVER HILL FUNDING, LLC TO MAKE ALL INQUIRES NECESSARY THAT VERIFY THE ACCURACY OF THE STATEMENTS MADE
HEREIN AND TO DETERMINE MY CREDITWORTHINESS.
Applicant Authorization/Signature: ____________________________ Social Sec. #: _________________ Date: ________________
Co-Applicant
I AUTHORIZE SILVER HILL FUNDING, LLC TO MAKE ALL INQUIRES NECESSARY THAT VERIFY THE ACCURACY OF THE STATEMENTS MADE HEREIN
AND TO DETERMINE MY CREDITWORTHINESS.
Co-Applicant Authorization/Signature: ____________________________ Social Sec. #: _________________ Date: ________________!
X. INFOR MATIO N #F O R #GOVE R N MENT#MONITO RING#PURPOSES
The purpose of collecting this information is to help ensure that all applicants are treated fairly and that the housing needs of communities and neighborhoods are being fulfilled. For
residential mortgage lending, federal law requires that we ask applicants for their demographic information (ethnicity, sex, and race) in order to monitor our compliance with equal credit
opportunity, fair housing, and home mortgage disclosure laws. You are not required to provide this information, but are encouraged to do so. The law provides that we may not
discriminate on the basis of this information, or on whether you choose to provide it. However, if you choose not to provide the information and you have made this application in person,
federal regulations require us to note your ethnicity, sex, and race on the basis of visual observation or surname. The law also provides that we may not discriminate on the basis or age
or marital status information you provide on this application.
Instructions: You may select one or more “Hispanic or Latino” origins and one or more designations for “Race.” If you do not wish to provide some or all of this information, select the
applicable check box.
BORROWER
ETHNICITY RACE
¨ Hispanic or Latino ¨ American Indian or Alaska Native-
¨ Mexican ¨ Puerto Rican ¨ Cuban
Mexican ¨ Puerto Rican ¨ Cuban
Enter name of enrolled or principal tribe:
¨ Other Hispanic or Latino – Enter Origin: ______________________________
¨ Asian
¨ Asian Indian ¨ Chinese ¨ Filipino
¨ Japanese ¨ Korean ¨ Vietnamese
_______________________________
Examples: Argentinian, Colombian,
Dominican, Nicaraguan, Salvadoran,
Spaniard, etc.
Other Asian – Enter race:_____________________
Ex: Hmong, Laotian, Thai, Pakistani, Cambodian, etc.
¨ Not Hispanic or Latino
¨ Black or African American
¨ Native Hawaiian or Other Pacific Islander
¨ I do not wish to provide this information ¨ Native Hawaiian ¨
Guamanian or Chamorro
¨ Samoan ¨ Other Pacific Islander –
SEX:
Enter race:_______________________________
¨ White
¨ Male
¨ Female
¨ I do not wish to provide this information ¨ I do not wish to provide this information
CO-BORROWER
ETHNICITY RACE
¨ Hispanic or Latino
¨
¨ American Indian or Alaska Native-
Enter name of enrolled or principal tribe:
¨ Other Hispanic or Latino – Enter Origin: ______________________________
¨ Asian
_______________________________ ¨ Asian Indian ¨ Chinese ¨ Filipino
Examples: Argentinian, Colombian, ¨ Japanese ¨ Korean ¨ Vietnamese
Dominican, Nicaraguan, Salvadoran,
Spaniard, etc.
Other Asian – Enter race:_____________________
Ex: Hmong, Laotian, Thai, Pakistani, Cambodian, etc.
¨ Black or African American
¨ Not Hispanic or Latino ¨ Native Hawaiian or Other Pacific Islander
¨ I do not wish to provide this information ¨ Native Hawaiian ¨
Guamanian or Chamorro
¨ Samoan ¨ Other Pacific Islander –
SEX:
Enter race:______________________________
¨ Male
¨ Female ¨ White
¨ I do not wish to provide this information ¨ I do not wish to provide this information
SHF Loan Application 11242020 Page 5 of 8
Applicant’s Initials: ____________
Co-Applicant’s Initials: ____________
To#Be#Completed#by#Financial#Institution#(for#application#taken#in#person):
Was the ethnicity of the Borrower collected on the basis of visual observation or surname? ¨ NO ¨ YES
Was the sex of the Borrower collected on the basis of visual observation or surname?
¨ NO ¨ YES
Was the race of the Borrower collected on the basis of visual observation or surname?
¨ NO ¨ YES
The#Demographic#Information#was#provided#through:
¨ Face-to-Face Interview (includes Electronic Media w/Video Component) ¨ Fax or Mail
¨ Telephone Interview ¨ Email
Closing Notes: (1) IRS Form 4506T to be signed prior to underwriting for all borrowers and businesses related to the transaction. (2) Signatures on all tax returns may be completed at
closing. This application is for a business purpose loan secured by commercial real estate. The undersigned specifically acknowledge and agree that (1) the loan requested by this
application will be secured by a first mortgage or deed of trust on the property described herein; (2) the property will not be used for any illegal or prohibited purposes or use; (3) all
statements made in this application are made for the purpose of obtaining the loan indicated herein; (4) occupation of the property will be as indicated above; (5) verification or
reverification of any information contained in the application may be made at any time by the Lender, its agents, successors and assigns, either directly or through a credit reporting
agency, from any source named in this application, and the original copy of this application will be retained by Lender, even if the loan is not approved; (6) the Lender, its agents,
successors and assigns will rely on the information contained in the application and I/we have continuing obligation to amend and/or supplement the information provided in this
application if any of the material facts which I/we have represented herein should change prior to closing; (7) In the event my/our payments on the loan indicated in this application
become delinquent, the Lender its agents, successors and assigns, may, in addition to all their other rights and remedies, report my/our name(s) and account information to a credit
reporting agency; (8) ownership of the loan may be transferred to successors or assigns of the Lender without notice to me and/or the administration of the loan account may be
transferred to an agent, successor or assign of the Lender with prior notice to me; (9) the Lender, its agents, successors and assigns make no representations of warranties, express or
implied, to the Borrower(s) regarding the property, the condition of the property, or the value of the property; and (10) I/we understand and hereby agree that all principals of the
company have been identified to the Lender and will sign the note personally guaranteeing repayment of the obligation. I/we the undersigned certify that the information provided in this
loan application and in all loan documents submitted to Lender is true and correct as of the date set forth opposite my/our signature(s) on this application and acknowledge my/our
understanding that any intentional or negligent misrepresentation 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 misrepresentation which I/we have made on this application.
Creditor's name: Silver Hill Funding, LLC. Creditor's address: 4425 Ponce de Leon Boulevard, 5th Floor, Coral Gables, Florida 33146
If your application for business credit is denied, you have the right to a written statement of the specific reasons for the denial. To obtain the statement, please contact Silver Hill
Funding, LLC at 4425 Ponce de Leon Boulevard, 5th Floor, Coral Gables, Florida, 33146 or by phone at 888.988.8843 within 60 days from the date you are notified of our decision. We
will send you a written statement of reasons for the denial within 30 days of receiving your request for the statement.
Notice: The federal Equal Credit Opportunity Act prohibits creditors from discriminating against credit applicants on the basis of race, color, religion, national origin, sex, sexual
orientation, marital status, age (provided the applicant has the capacity to enter into a binding contract); because all or part of the applicant's income derives from any public assistance
program; or because the applicant has in good faith exercised any right under the Consumer Credit Protection Act. The federal agency that administers compliance with this law
concerning this creditor is Federal Trade Commission, Equal Credit Opportunity, Washington, D.C., 20580.
SHF Loan Application 11242020 Page 6 of 8
I. PERSONAL OR BORROWING ENTITY INFORMATION – continued.
Co-Borrower 3 Name:
Co-Borrower 4 Name:
Social Security #:
Date of Birth:
Social Security #:
Date of Birth:
Marital Status:
¨ Married ¨ Single ¨ Divorced
Marital Status:
¨ Married ¨ Single ¨ Divorced
Address 1:
Address 1:
Address 2:
Address 2:
City:
State:
Zip:
City:
State:
Zip:
Phone Number:
Phone Number:
Email Address:
Email Address:
V. EMPLOYMENT INFORMATION – continued.
Self Employed:
¨ Yes ¨ No
Self Employed:
¨ Yes ¨ No
Years on the Job:
Years on the Job:
VI. ANNUAL PERSONAL INCOME AND MONTHLY LIABILITIES
Assets
Liabilities
Total Assets: $ Total Liabilities: $
Total Cash Available: $
(Savings and Checking)
Net Worth: $
If you answer “Yes” to any questions A through H, please provide a separate explanation. Co-Borrower 3 Co-Borrower 4
A. Are there any outstanding judgments against you? ¨ Yes ¨ No ¨ Yes ¨ No
B. Have you declared bankruptcy within the last 4 years? ¨ Yes ¨ No ¨ Yes ¨ No
C. Have you had property foreclosed upon or given title in lieu thereof in the last 4 years? ¨ Yes ¨ No ¨ Yes ¨ No
D. Are you party to a lawsuit? ¨ Yes ¨ No ¨ Yes ¨ No
E. Have you directly or indirectly been obligated on any loan which resulted in foreclosure, transfer of title
in lieu of foreclosure or judgment in the last 4 years?
¨ Yes ¨ No ¨ Yes ¨ No
F. Are you presently delinquent or in default on any Federal debt or any other loan, mortgage, financial
obligation or loan guarantee?
¨ Yes ¨ No ¨ Yes ¨ No
G. Are you presently in forbearance on any Federal debt or any other
loan, mortgage, financial
¨ Yes ¨ No
¨ Yes ¨ No
H. Are you presently in a loan modification plan or have been in a loan modification plan in the
¨ Yes ¨ No
¨ Yes ¨ No
K. Have y
ou been
c
onvicted of
a
felony
within
the past 10 years?
¨ Yes ¨ No
¨ Yes ¨ No
L. Ar
e you
a
U.S.
citizen? ¨ Yes ¨ No
¨ Yes ¨ No
M. Ar
e y
ou a
permanent
resident
alien?
¨ Yes ¨ No
¨ Yes ¨ No
If you answered no to questions L and M, please provide
visa status:
I. Are you obligated to pay alimony, child s
upport or separate maintenance?
¨ Yes ¨ No
¨ Yes ¨ No
J. If applicable, do y
ou intend to occupy the property as your primary housing residence?
¨ Yes ¨ No
¨ Yes ¨ No
obligation, bond or loan guarantee?
previous 24 months?
VIII. PERSONAL DECLARATIONS – continued.
Net ANNUAL Income:
Co-Borrower 3
Co-Borrower 4
Total Income:
$
$
Total MONTHLY Liabilities List all personal and business liabilities
(Example: car payments, equipment leases, and housing expense)
$
VII. ASSETS AND LIABILITIES – continued.
0
SHF Loan Application 11242020 Page 7of 8
X. GENERAL#AUTHORIZATION#–#continued.
I HEREBY AUTHORIZE SILVER HILL FUNDING, LLC, AND ITS SUCCESSORS AND/OR ASSIGNS AS THEIR INTEREST MAY APPEAR, TO VERIFY ANY
AND ALL INFORMATION PROVIDED OR REQUESTED WITH THIS APPLICATION, INCLUDING BUT NOT LIMITED TO MY PAST AND PRESENT
EMPLOYMENT, EARNING RECORDS, BANK ACCOUNTS, STOCK HOLDINGS AND ANY OTHER ASSET BALANCES NEEDED TO PROCESS MY LOAN
APPLICATION.
I UNDERSTAND THAT FALSE INFORMATION AND STATEMENTS MAY RESULT IN POSSIBLE PROSECUTION UNDER FEDERAL AND STATE LAWS.
FURTHER, I UNDERSTAND THAT MY INFORMATION WILL BE SCRUBBED AGAINST THE OFAC, SDN LISTS, EXCLUSIONARY AND OTHER LISTS TO
CONFIRM COMPLIANCE WITH THE US PATRIOT ACT, COUNTER-TERRORISM REGULATIONS AND BSA/AML REGULATIONS.
I CERTIFY BY SIGNING BELOW THAT THIS IS NOT AN APPROVAL OR COMMITMENT TO LEND AND THAT I MAY BY DENIED AT ANY TIME DURING THE
PROCESS FOR REASONS INCLUDING BUT NOT LIMITED TO CREDIT WORTHINESS SUCH AS; COLLATERAL ISSUES, BUSINESS PRACTICES OR
UNSTABLE GOVERNMENT/POLITICAL CLIMATE WITHIN A COUNTRY.
Applicant
I AUTHORIZE SILVER HILL FUNDING, LLC TO MAKE ALL INQUIRES NECESSARY THAT VERIFY THE ACCURACY OF THE STATEMENTS MADE
HEREIN AND TO DETERMINE MY CREDITWORTHINESS.
Applicant Authorization/Signature: ____________________________ Social Sec. #: _________________ Date: ________________
Co-Applicant
I AUTHORIZE SILVER HILL FUNDING, LLC TO MAKE ALL INQUIRES NECESSARY THAT VERIFY THE ACCURACY OF THE STATEMENTS MADE
HEREIN AND TO DETERMINE MY CREDITWORTHINESS.
Co-Applicant Authorization/Signature: ____________________________ Social Sec. #: _________________ Date: ________________
XI. INFORMATION#FOR#GOVERNMENT#MONITORING#PURPOSES
The purpose of collecting this information is to help ensure that all applicants are treated fairly and that the housing needs of communities and neighborhoods are being fulfilled.
For residential mortgage lending, federal law requires that we ask applicants for their demographic information (ethnicity, sex, and race) in order to monitor our compliance with equal
credit opportunity, fair housing, and home mortgage disclosure laws. You are not required to provide this information, but are encouraged to do so. The law provides that we may not
discriminate on the basis of this information, or on whether you choose to provide it. However, if you choose not to provide the information and you have made this application in
person, federal regulations require us to note your ethnicity, sex, and race on the basis of visual observation or surname. The law also provides that we may not discriminate on the
basis or age or marital status information you provide on this application.
Instructions: You may select one or more “Hispanic or Latino” origins and one or more designations for “Race.” If you do not wish to provide some or all of this information, select the
applicable check box.
BORROWER
ETHNICITY RACE
¨ Hispanic or Latino ¨ American Indian or Alaska Native-
¨ Mexican ¨ Puerto Rican ¨ Cuban Enter name of enrolled or principal tribe:
¨ Other Hispanic or Latino – Enter Origin: ______________________________
¨ Asian
_______________________________ ¨ Asian Indian ¨ Chinese ¨ Filipino
Examples: Argentinian, Colombian, ¨ Japanese ¨ Korean ¨ Vietnamese
Dominican, Nicaraguan, Salvadoran, Other Asian – Enter race:_____________________
Spaniard, etc. Ex: Hmong, Laotian, Thai, Pakistani, Cambodian, etc.
¨ Black or African American
¨ Not Hispanic or Latino ¨ Native Hawaiian or Other Pacific Islander
¨ I do not wish to provide this information ¨ Native Hawaiian ¨
Guamanian or Chamorro
¨ Samoan ¨ Other Pacific Islander –
SEX:
¨ Male
Enter race:_______________________________
¨ Female ¨ White
¨ I do not wish to provide this information ¨ I do not wish to provide this information
CO-BORROWER
ETHNICITY RACE
¨ Hispanic or Latino ¨ American Indian or Alaska Native-
¨ Mexican ¨ Puerto Rican ¨ Cuban Enter name of enrolled or principal tribe:
¨ Other Hispanic or Latino – Enter Origin: ______________________________
¨ Asian
_______________________________ ¨ Asian Indian ¨ Chinese ¨ Filipino
Examples: Argentinian, Colombian, ¨ Japanese ¨ Korean ¨ Vietnamese
Dominican, Nicaraguan, Salvadoran, Other Asian – Enter race:___________________
Spaniard, etc. Ex: Hmong, Laotian, Thai, Pakistani, Cambodian, etc.
¨ Black or African American
¨ Not Hispanic or Latino ¨ Native Hawaiian or Other Pacific Islander
¨ I do not wish to provide this information ¨ Native Hawaiian ¨ Guamanian or Chamorro
¨ Samoan ¨ Other Pacific Islander –
SEX:
¨ Male Enter race:_______________________________
¨ Female ¨ White
¨ I do not wish to provide this information ¨ I do not wish to provide this information
To#Be#Completed#by#Financial#Institution#(for#application#taken#in#person):
Was the ethnicity of the Borrower collected on the basis of visual observation or surname? ¨ NO ¨ YES
Was the sex of the Borrower collected on the basis of visual observation or surname?
¨ NO ¨ YES
Was the race of t
he Borrower collected on the basis of visual observation or surname?
¨ NO ¨ YES
The#Demographic#Informa tio n #w a s #p ro v id e d #th ro u g h :
¨ Face-to-Face Interview (includes Electronic Media w/Video Component) ¨ Fax or Mail
¨ Telephone Interview ¨ Email
SHF Loan Application 11242020 Page 8 of 8
Co-Applicant 3 Initials:
____________
Co-Applicant 4 Initials:
____________
Closing Notes: (
1) IRS Form 4506T to be signed prior to underwriting for all borrowers and businesses related to the transaction. (2) Signatures on all tax returns may be completed at
closing. This application is for a business purpose loan secured by commercial real estate. The undersigned specifically acknowledge and agree that (1) the loan requested by this
application will be secured by a first mortgage or deed of trust on the property described herein; (2) the property will not be used for any illegal or prohibited purposes or use; (3) all
statements made in this application are made for the purpose of obtaining the loan indicated herein; (4) occupation of the property will be as indicated above; (5) verification or
reverification of any information contained in the application may be made at any time by the Lender, its agents, successors and assigns, either directly or through a credit reporting
agency, from any source named in this application, and the original copy of this application will be retained by Lender, even if the loan is not approved; (6) the Lender, its agents,
successors and assigns will rely on the information contained in the application and I/we have continuing obligation to amend and/or supplement the information provided in this
application if any of the material facts which I/we have represented herein should change prior to closing; (7) In the event my/our payments on the loan indicated in this application
become delinquent, the Lender, its agents, successors and assigns, may, in addition to all their other rights and remedies, report my/our name(s) and account information to a credit
reporting agency; (8) ownership of the loan may be transferred to successors or assigns of the Lender without notice to me and/or the administration of the loan account may be
transferred to an agent, successor or assign of the Lender with prior notice to me; (9) the Lender, its agents, successors and assigns make no representations of warranties, express or
implied, to the Borrower(s) regarding the property, the condition of the property, or the value of the property; and (10) I/we understand and hereby agree that all principals of the company
have been identified to the Lender and will sign the note personally guaranteeing repayment of the obligation. I/we the undersigned certify that the information provided in this loan
application and in all loan documents submitted to Lender is true and correct as of the date set forth opposite my/our signature(s) on this application and acknowledge my/our
understanding that any intentional or negligent misrepresentation 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 misrepresentation which I/we have made on this application.
Creditor's name: Silver Hill Fund
ing, LLC. Creditor's address: 4425 Ponce de Leon Boulevard, 5th Floor, Coral Gables, Florida 33146
If your application for business credit is denied, you have the right to a written statement of the specific reasons for the denial. To obtain the statement, please contact Silver Hill
Funding, LLC at 4425 Ponce de Leon Boulevard, 5th Floor, Coral Gables, Florida, 33146 or by phone at 888.988.8843 within 60 days from the date you are notified of our decision. We
will send you a written statement of reasons for the denial within 30 days of receiving your request for the statement.
Notice: The federal Equal Credit Opportunity Act prohibits creditors from discriminating against credit applicants on the basis of race, color, religio
n, national origin, sex, sexual
orientation, marital status, age (provided the applicant has the capacity to enter into a binding contract); because all or part of the applicant's income derives from any public assistance
program; or because the applicant has in good faith exercised any right under the Consumer Credit Protection Act. The federal agency that administers compliance with this law
concerning this creditor is Federal Trade Commission, Equal Credit Opportunity, Washington, D.C., 20580.
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

- SHF Loan Application V10062020

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 22 February 2021

Message

View Audit Log
Print With Audit Log
Duplicate Document