The ________________________________ (“Financial Institution”), of the city of _______________________, hereby
applies for approval as a lender under the Finally Home Program (“Program”). Financial Institution acknowledges that, in
order to participate in the Program, Financial Institution must be an FDIC-insured banking institution and have an IDC
Financial Publishing, Inc. (“IDC”) rating of at least 75. Financial Institution further acknowledges that all loans that are
guaranteed by the Office of the Illinois State Treasurer (“Treasurer”) under the Program must comply with the Deposit of
State Moneys Act, 15 ILCS 520/7, Article V of the Illinois Residential Mortgage License Act of 1987, 205 ILCS 635, and
the Treasurer’s Program Guidelines, available at www.illinoistreasurer.gov.
I hereby attest and certify that the following statements are true and accurate:
1. My job title is of Financial Institution, and I am authorized to execute
this application on behalf of Financial Institution;
2. I
have such familiarity with the business and affairs of Financial Institution so as to be able to knowledgeabl
y
m
ake the statements set forth in this attestation and certification;
3. I
understand that the Treasurer will rely, in part, on the statements set forth herein in connection with determining
whether Financial Institution will be approved as a lender under the Program;
4. Financial Institution is an FDIC-insured banking institution with an FDIC Number of ; and
5. Financial Institution is an Illinois or national bank that is authorized to do business in Illinois and has a presence in
Illinois.
Name of Financial Institution: _____________
Authorized Representative (Printed):
Title:
Address:
Telephone Number:
Fax Number:
E-mail Address
:
Authorized Representative Signature: __________________________________ Date: _________________________
SUBSCRIBED and SWORN to before me (Notary signature date should match that of the authorized
representative signature date)
(Notary Public Signature)________________________________________ This _____ day of _________, _______.
Following the Treasurer’s approval of this application, Financial Institution will receive a Finally Home Agreement
between Financial Institution and Treasurer that must be executed and return to the Treasurer within ten days of receipt.
Please return this application to:
Finally Home Program
Office
Office of the Illinois State Treasurer
1 East Old State Capitol Plaza
Springfield, IL 62701
E-mail: finallyhome@illinoistreasurer.gov
Phone (866) 458-7327 or (217) 557-6436 | Fax (217) 557-6439
Notary Seal
For Office Use Only
IDC
