New Individual Input Form - TaliMar Financial

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Are you working with an Account Representative? *

Select the name of your Account Representative? *

Name *

First

Last

Full Legal Name *

Phone *

Email *

Primary Residence Address *

Address Line 1

Address Line 2

City

State

Zip Code

Do you own this residence? *

Is your Mailing Address the same? *

Mailing Address *

Address Line 1

Address Line 2

City

State

Zip Code

Date of Birth *

Social Security Number *

Drivers License Number *

State Issued *

Expiration Date *

Marital Status *

Single
Married
Seperated
Divorced
Widowed
Other

Explain *

Ethnicity Questionnaire *

No, I will NOT furnish this information

The following information is requested by the federal government for certain types of loans related to a dwelling in order to monitor the lender's compliance with equal credit opportunity, fair housing and home mortgage disclosure laws. You are not required to furnish this information, but are encouraged to do so. You may select one or more designations for "Race." The law provides that a lender may not discriminate on the basis of this information, nor on whether you choose to furnish it. However, if you choose not to furnish the information and you have made this application in person, under federal regulations, the lender is required to note ethnicity, race, and sex on the basis of visual observation or surname. If you do not wish to furnish the information, please initial below.

Ethnicity *

Hispanic or Latino
Not Hispanic or Latino

Race *

American Indian or Alaska Native
Black or African American
Native Hawaiian or Other Pacific Islander
Asian
White

Sex *

Female
Male

Employment Information

Though we don't have a income requirement for most of our loan programs, we do want to establish that ability to make the monthly payment on the loan.

What is your Employment Status

W2
Self Employed
Not Employed
Retired
Other

Explain *

Primary Employer Name *

Years at Employer *

Title *

Address of Employer *

Address Line 1

Address Line 2

City

State

Zip Code

Prior Year Gross Income *

Approximate Year to Date Income *

Have you filed your prior year income tax return? *

Explain status of tax filing *

What is your approximate credit score? *

Please note TaliMar Financial will not pull your credit unless we have written authorization to do so.

Explain any derogatory credit items that may appear on your credit.

Are you a US citizen? *

If Yes, please explain *

Are you involved in any pending litigation? *

If Yes, please explain *

Have you been convicted of a felony? *

If Yes, please explain *

Have you declared bankruptcy in the last 7 years *

If Yes, please explain *

Have you had a property foreclosed upon or given title or deed in lieu in the last 7 years? *

If Yes, please explain *

Have you directly or indirectly been obligated on any loan of which resulted in foreclosure, transfer of title in lieu of foreclosure, or judgement? *

(This would include such loans as home loans, SBA loans, home improvement loans, educational loans, manufactured (mobile) home loans, any mortgage, financial obligation, bond, or loan guarantee. If "Yes" provide details, including date, name, and address of Lender, FHA, or VA cash number, if any, and reasons for the action)

If Yes, please explain *

Are you presently deliquent or in default of any Federal debt or any other loan, mortgage, financial obligation, bond, or loan guarantee? *

If Yes, please explain *

Are you a co-maker or endorser on a note? *

If Yes, please explain *

Are you required to pay alimony, child support, or separate maintenance? *

If Yes, please explain *

Do you have any existing / prior tax liens or judgements? *

If Yes, please explain *

Investment Experience

Do you own a rental property?

If YES, you may also submit a Real Estate Schedule.

How many Rental Properties do you own? *

Have you flipped a Property in the last 24 Months? *

How many properties have you flipped in the last 24 Months? *

Share any additional experience in real estate that would help us evaluate your experience *

At TaliMar Financial, we are committed to protecting the privacy and security of your personal information. We do not sell or distribute any personal or financial information to third parties for marketing or other commercial purposes. However, to facilitate the administration and servicing of loans, we may share necessary borrower information with a third-party loan servicer that complies with all applicable California consumer protection laws. This servicer is required to adhere to strict confidentiality and data protection standards to ensure the security of your information. By selecting Acknowledge, you consent to the limited sharing of your information for the sole purpose of loan servicing. I acknowledge that I have read and understand this notice. I consent to the limited sharing of my personal and financial information with a qualified loan servicer as described above.

Acknowledge

Signature *

Clear Signature

I/We fully understand that is is a Federal crime punishable by fine or imprisonment, or both, to knowingly make any false statements concerning any of the above facts as applicable under the provisions of Title 18, United States Code, Seciton 1001, et. seq.