Alan Breecker

Senior Loan Consultant

904-685-5131

Home Improvement Loan Application

Requested Loan Amount *

This loan application is for loan amounts >$15,000.

Please apply through our partner, Lendvious, for small loan sizes - Click here to apply.

Is there a Co-Borrower? *

Yes

No

Co-Borrower Relationship to Borrower *

Spouse

Parent

Friend

Relative

Borrower Information

First Name *

Last Name *

Email Address *

Cell Phone (###-###-####) *

Home Number (###-###-####) *

Citizenship *

US Citizen

Permanent Resident

Non-US Citizen

Date of Birth (MM/DD/YYYY) * +

Social Security Number - (###-##-####) *

Driver's License Number *

Driver's License Issuing State *

License Expiration Date (MM/DD/YYYY) * +

Employment Type *

Employed

Self Employed

Retired

Not Employed

Borrower Gross Annual Income (all sources) *

Current Employer *

Occupation / Job Title *

Years and months at this job

Years *

Months *

Military Affiliation *

Co-Borrower Information

Co-Borrower First Name *

Co-Borrower Last Name *

Co-Borrower Email Address *

Co-Borrower Phone Number (###-###-####) *

Co-Borrower Date of Birth (MM/DD/YYYY) * +

Co-Borrower Social Security Number - (###-##-####) *

Co-Borrower Driver's License Number *

Co-Borrower Driver's License Issuing State *

Co-Borrower License Expiration Date (MM/DD/YYYY) * +

Co-Borrower Employment Type *

Employed

Self Employed

Retired

Not Employed

Co-Borrower Gross Annual Income (all sources) *

Co-Borrower Current Employer *

Co-Borrower Occupation / Job Title *

Co-Borrower Years and months at this job

Years *

Months *

Co-Borrower Military Affiliation? *

Property Information

Is Property Your Primary Residence? *

Yes

No

Is Property a Single-Family Residence? *

Yes

No

Address *

City *

State *

ZIP *

Month and Year Home was Purchased

Month *

Year *

1st Mortgage Balance *

Monthly Mortgage Payment $ *

Mortgage Type *

Project Information

Purpose of Loan *

Swimming Pool

Other Home Improvement

Pool Builder Name (or list TBD) *

Pool Designer Name / Contact Name

How did you hear about us? *

Comments

CREDIT REPORT AUTHORIZATION AGREEMENT

Authorization is hereby granted to Viking Capital, Inc., or it's designated Lender to obtain a consumer credit report through a credit reporting agency chosen by Viking Capital, Inc. or its designated Lender. I understand and agree that Viking Capital, Inc. and the designated Lender intend to use the consumer credit report for the purposes of evaluating my financial readiness to obtain a loan.

I understand that this credit report will be retained on file at the Viking Capital, Inc. or Lender office for use only by Viking Capital, Inc. or Lender staff. This information will not be disclosed to anyone by Viking Capital, Inc. or the Lender without my written consent.

My acknowledgement below authorizes the release to the credit reporting agency of financial information which I have supplied to Viking Capital, Inc. in connection with such an evaluation. Authorization is further granted to the credit reporting agency to use photostatic reproduction of this form if required to obtain any information necessary to complete my consumer credit report.

BY CHECKING THE BOX BELOW, (1) I have read and agree to the E-Sign Disclosure and Consent Act, and acknowledge that I can open PDFs; (2) I am authorizing the lender or lender's agent to notify the contractor about the lender's decision to approve or deny the loan I am applying for, which may include my unique loan ID and information I provide during the application process; and (3) I am authorizing lender or lender's agent to notify Viking Capital, Inc. about the status of my loan application and any applicable loan terms.

BY CHECKING THE BOX BELOW, I acknowledge that Viking Capital's responsibilities in the loan process vary with each lender and with each loan I may select. I understand that Viking Capital may receive compensation from the lender for some services performed and I may be charged a reasonable consulting fee for other services provided. The exact amount of that fee will be disclosed to me upon loan approval and I agree to pay the fee for this service prior to accessing the funds. I understand that Viking Capital will not request compensation if I am not approved for a loan. If I gain access to the funds prior to paying the fee, I understand that does not release me from my obligation to pay Viking Capital for their services. Non-payment of the fee may result in collection activity that can affect my credit negatively.

Credit Union Membership Disclosure: Your loan may be approved by a credit union. Only credit union members are allowed to receive a loan from a credit union. If you are conditionally approved for this loan, you will be able to join the credit union that you select below. If you choose to cancel your loan request, there is no further obligation or requirement to remain a member of the credit union. Credit unions have varying membership criteria and may require a small deposit (usually $5.00) into an account that you open with the credit union and/or an association fee to join the credit union as a new member.

CHECKING THE "I AGREE" BOX BELOW GRANTS PERMISSION FOR THE RELEASE OF FINANCIAL INFORMATION TO THE CREDIT REPORTING AGENCY AND GRANTS PERMISSION FOR Viking Capital, Inc. TO OBTAIN A COPY OF YOUR CREDIT REPORT.

Check Box *

I Agree

A Soft Credit Pull is requested for: *