Fillable CREDIT APPLICATION This is not a contract for (Energy Finance Solutions)

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CREDIT APPLICATION This is not a contract for (Energy Finance Solutions)

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CREDIT APPLICATION
This is not a contract for a loan nor does it lock you into any commitment with a contractor. This is an application that will allow us to proceed with
your request for a loan to finance your energy improvement(s). This will include reviewing your utility bill repayment, tax and credit history.
Please complete all fields. Incomplete applications will be returned to you for completion. Only residential work that has not been started is eligible
for financing. All owners must be applicants. If there are more than two property owners, please complete additional application forms. Upon
completion of the application, please submit all requested items to:
Energy Finance Solutions, 431 Charmany Drive, Madison, WI 53719 or fax to 608.249.5788
SECTION A – INDIVIDUAL APPLICANT INFORMATION
Note: If the property is owned by a trust, the trust has to apply as a joint applicant in Section C.
Mr/Mrs/Ms
Last Name
First Name
MI
Jr/Sr/I/II/III
Birth Date
Home Phone
Social Security Number
Installation Address (where home improvements are to be made)
Unit #
City
State
Zip
How are you associated with the installation property?
Own Rent
Who resides at the installation property?
Owner Tenant
If owner, how many years have you owned the installation property?
Current Address (if different from the installation property)
City
State
Zip
Mailing Address (if different from the installation property)
City
State
Zip
SECTION B – JOINT APPLICANT
Complete only for joint credit. Joint applicant must own and occupy the home at the above installation address.
Mr/Mrs/Ms
Last Name
First Name
MI
Jr/Sr/I/II/III
Birth Date
Home Phone
Social Security Number
Current Address (if different from the installation property)
City
State
Zip
How are you associated with the installation property?
Own Rent
Who resides at the installation property?
Owner Tenant
If owner, how many years have you owned the installation property?
SECTION C – TRUSTS
If the property is held in a trust, list the name of the trust, the name of each trust signatory and the associated title of the trust signatory.
Name of the Trust
Signatory Name
Signatory Title
Signatory Name
Signatory Title
CREDIT APPLICATION
SECTION D – UTILITY INFORMATION
Electric Utility Co.
Gas Utility Co.
Have you paid your electric utility bill on time in the last 12 months? Yes No
SECTION E – CONTRACTOR
Contractor (leave blank if not selected yet):
SECTION F – DESIRED LOAN TERM
The desired loan term will be applied unless the useful life of the measures installed is less than the desired loan term.
Select Desired Loan Term: 5 years 6 years 7years 8 years 9 years 10 years
11 years 12 years 13 years 14 years 15 years
SECTION G – ASSET AND DEBT INFORMATION
If Section B has been completed, include information about both the applicant and joint applicant.
Are there any delinquent property taxes associated with the installation address? Yes No
Are there any unsatisfied judgments against you?
Yes No
If yes, to whom owed?
Total Amount Owed
$
Have you declared bankruptcy discharged in the last 3 years?
Yes No
If yes, which city/state?
Year
By completing and submitting an application, I/we certify that I/we am/are of legal contracting age and that I/we have read, understood and agree to all
of the terms stated here. By signing below, I/we certify that all information provided on this application is correct and complete to the best of my/our
knowledge. My/our signature(s) also authorizes Energy Finance Solutions (EFS), a service offered by Wisconsin Energy Conservation Corporation
(WECC), or a lender of choice, to obtain my/our utility bill repayment history, delinquent tax, and property owner information from the City of Holland.
My/our signature(s) further authorize EFS to obtain a credit report(s) in connection with my/our loan request. If necessary, I/we further agree to provide
additional information to WECC/EFS, or lender of choice, to underwrite my/our loan request. I/We further understand and authorize EFS and WECC to
retain this application whether or not it is approved. Additionally, if this application is approved and the loan I/we have requested is made, I/we also
authorize WECC/EFS to share such information concerning: my/our electric and/or gas utility billing account number; the charges payable by me/us
under the promissory note that I/we will sign; and other non-public information that I/we provided for the purpose of underwriting and servicing my/our
loan.
I/We understand and agree that EFS and WECC do not guarantee the security of any data submitted electronically and will not be held responsible or
liable for interception by third parties. I/We understand and agree that in no event will EFS or WECC be liable for any technical, hardware or software
failure of any kind, any interruption in the availability of this service, any delay in operation or transmission, any incomplete transmission, computer
virus, loss of data, or other similar loss.
The Federal Equal Credit Opportunity Act prohibits creditors from discriminating against credit applications on the basis of race, color, religion, national
origin, sex, marital status or age.
Applicant’s Signature
Date
Joint Applicant’s Signature
Date
Applicant’s Email Address
Joint Applicant’s Email Address
Apply online at www.energyfinancesolutions.com
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CREDIT APPLICATION This is not a contract for (Energy Finance Solutions)

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Completed 21 March 2021

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