Fillable SECTION A INDIVIDUAL APPLICANT INFORMATION Apply online at (Energy Finance Solutions)

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SECTION A INDIVIDUAL APPLICANT INFORMATION Apply online at (Energy Finance Solutions)

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CREDIT APPLICATION
Apply online at www.energyfinancesolutions.com
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 improvement(s). This will include reviewing your credit history.
Pleas
e complete all fields. Incomplete applications will be returned to you for completion. If additional information is needed, you will be notified of
the specific documentation required to process your application. Only residential work that has not been started is eligible for financing. 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
Title
Last Name
First Name
MI
Suffix
Birth Date
Social Security Number
Phone Number
Installation Address (where home improvements are to be made)
City
State
Zip
Do you currently
Own Rent
Years at Current Address
Do or will you own and reside at
the above installation address?
Yes No
Dwelling Type (Multi (3 units +) does not quality)
Single Family Duplex Other
Current Address (if different than the above installation address)
City
State
Zip
Mailing Address (if different than the above current address)
City
State
Zip
SECTION B – JOINT APPLICANT
Complete only for joint credit (If Joint Applicant is a Co-Borrower/Spouse then they must own and occupy the home at the above installation address.)
Title
Last Name
First Name
MI
Suffix
Birth Date
Social Security Number
Phone Number
Current Address (if different than the above installation address)
City
State
Zip
Do you currently
Own Rent
Years at Current Address
Do or will you own and reside at the above installation address?
Yes No
SECTION C – UTILITY INFORMATION
Electric Utility Co.
Gas Utility Co.
Water Heating Fuel Type (select one)
Natural Gas Electric
LP Oil Other
Space Heating Fuel Type (select one)
Natural Gas Electric
LP Oil Other
South Jersey Gas Account Number:
If you’re not currently a SJG customer, will you become a customer as a result of
the improvements you plan to make and pay for with this financing?
Yes No
Have you been a customer with SJG for at least 12 months? Yes No
SECTION D – MEASURES INSTALLATION INFORMATION
(Please print clearly and include a copy of your contractor’s estimate, if available at this time.)
Measure(s) To be Installed
Efficiency Level
Contractor Doing the Work (name/address)
Cost *
$
$
$
TOTAL COST: $
*Include any associated costs such as venting, wiring, or other electrical work, warranties, etc.
CREDIT APPLICATION
SECTION E – DISCLOSURES & SIGNATURE(S)
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. I/We represent that the information I/we provide will be true, accurate and complete.
I/We acknowledge that South Jersey Gas (“SJG”) has retained Energy Finance Solutions (“EFS”), a service offered by Slipstream Group
Inc. (“Slipstream”), to process this application and underwrite my/our loan, and it is expected that, after the loan has been approved and
funded by EFS, EFS will transfer my/our loan to SJG.
I/We understand and authorize EFS and Slipstream to start a credit investigation based on the information voluntarily provided by me/us.
This application reflects all my/our current debts and my/our signature(s) below authorizes EFS, Slipstream, or a lender of choice, to
obtain credit reports in connection with my/our loan request. If necessary, I/we further agree to provide additional information to EFS,
Slipstream, or lender of choice, to underwrite my/our loan request. I/We further understand and authorize EFS and Slipstream to retain
this application whether or not it is approved. In addition, if this application is approved and the loan I/we have requested is made, I/we
also authorize SJG and its employees and agents to share such information concerning: my/our electric and/or gas utility usage and
billing information; the charges payable by me/us under the promissory note that I/we will sign; and other non-public information that I/we
provided.
I/We understand and agree that EFS and Slipstream 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 Slipstream 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.
To be eligible for financing, your work must be approved by the program and completed by an Eligible Contractor. The list of Eligible
Contractors is provided on behalf of SJG as an informational source only. The publication or sharing of this list should not be considered,
in any way, to be an endorsement, recommendation or promotion, either expressed or implied, of any of the Eligible Contractors listed
therein. Accordingly, it is the customer’s sole responsibility to investigate and determine the technical capabilities and reliability of the
Eligible Contractors prior to entering into a contract for services provided by any Eligible Contractor. Customers agree that their selection
of any of the Eligible Contractors on this list is completely voluntary and made without any recommendation, promise, guarantee,
coercion, threat or force by SJG. By signing this contract, you expressly agree to the terms of the above disclaimer.
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.
Whether or not the undersigned have elected to sign this document electronically, EFS, and or any subsequent holders of this document,
shall have the right to convert and store the manual signature electronically and the undersigned consents to the use of the electronically
stored version in the same manner as an original signed copy.
I understand and intend that a legal signature is formed by entering my name on this and other documents provided to me, and by
entering my name on this and other documents provided in relation to this transaction I intend for my electronic signature to have the
same force and effect as my manual signature. If any of the parties do not wish to sign this document electronically, all must opt out
together and request a paper copy to sign manually.
By entering my name below, I am creating a legally binding signature and confirm that I agree and accept the signature terms and
conditions.
Applicant’s Signature
Date
Joint Applicant’s Signature
Date
Applicant’s Email Address
Joint Applicant’s Email Address
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SECTION A INDIVIDUAL APPLICANT INFORMATION Apply online at (Energy Finance Solutions)

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Completed 21 March 2021

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