ZoiFlow Funding Intake

First Name *

Middle Name

Last Name * Email * Confirm Email * Phone

Who referred you?

SSN Date of Birth Citizenship

Physical Address

Address Line 1 Address Line 2

City

State

Zip Same as physical?

Mailing Address 1 Mailing Address 2

Mailing City

Mailing State

Mailing Zip

Education Level School Name Area Of Study Graduation Year

Employment Status Job Title Employer Name Employer Phone Employer Address 1 Employer Address 2

Employer City

Employer State

Employer Zip Employment Duration

Years

Months

Occupancy Status Occupancy Duration

Years

Months

Monthly Housing Payment

Annual Personal Income Annual Business Income

ID Front ID Back

SSN Card Selfie with ID Proof of Residence

Paystub 1 (optional) Paystub 2 (optional)

Bank Statement 1 Bank Statement 2 Bank Statement 3

  credit authoirziation
  By Clicking I agree and authorize Optenics LLC dba ZoiFlow. to obtain a tri-merged consumer credit report through
  I/We understand that intends to use the credit report for the purposes of confirming my/our residency address, verifying other credit information, including past and present mortgages, and evaluating whether my/our income is eligible to support the school loans, training loans,  business and personal loans, lines of credit and credit cards, mortgage loans, commercial loans, construction loans, or auto loans. for which I/we have applied.

  I/We understand that in conjunction with the tri-merged credit report that may ask me/us to verify past and present employment earnings records, bank accounts, stock holdings, and any other asset balances that are needed to process the mortgage loan application. I/We understand that the credit report obtained is to be used solely in the processing of the loan
  application and that this information may only be shared with other agencies that have a direct connection
  with the processing of the mortgage loan application. I/We understand that credit inquiries have the potential to impact my/our credit score. It is understood understand that this tri-merged credit report will be retained on file by along with all other loan application documents. This authorization expires 120 days from the date indicated below.

  FEDERAL EQUAL CREDIT OPPORTUNITY ACT:
  The Federal Equal Credit Opportunity Act prohibits creditors from discriminating against credit applicants on the basis of race, color, religion,national origin, sex, marital status, age (provided the applicant has the capacity to enter into a binding contract); because all or part of the applicant's income derives from any public assistance program; or because the applicant has in good faith exercised any right under the Consumer Credit Protection Act. The Federal Agency that administers compliance with this law concerning this company is the Office of the Comptroller of the Currency, Customer Assistance Group.

  consent_agreed

Consent Agreed Signature Name

ZoiFlow Funding Intake

Physical Address

Thank You!