Credit Inquiry and Payment Authorization Form

Applicant Name(Required)

First Last

Email(Required)

Phone(Required)

Credit Authorization: I/We hereby authorize Prime Choice Funding Inc to obtain a copy of my/our credit report and any additional information necessary for mortgage loan qualification and processing. Prime Choice Funding Inc will request this credit report through either Informative Research or Xactus, our authorized credit reporting vendors. I/We understand that Informative Research and Xactus are trusted third-party providers of credit reporting services to the mortgage industry and that Prime Choice Funding Inc may use either of these vendors to access my/our credit profile. I/We further acknowledge that I/we am/are solely responsible for the charge associated with this credit report, regardless of the outcome of the loan application or loan decision, and that this credit inquiry does not constitute a loan approval. This authorization also permits Prime Choice Funding Inc to share this credit information with its lending partners or affiliates as necessary to complete the mortgage loan transaction.

Please select how you will provide your credit card information. You must complete the form regardless of your selection.(Required)

I will provide my credit card information directly to the loan officer, who will contact me to collect it.

I prefer to enter my credit card information on this form.

Credit Card Type:(Required)

Visa

MasterCard

Discover

Amex

Credit Card #:(Required)

Expiration Date:(Required)

Credit Report Fee: Up to $(Required)

CVV/CVC (Security Code):(Required)

(Visa/MasterCard: 3 digits on back | AMEX: 4 digits on front)

Name on Card:(Required)

Billing Address:(Required)

Street Address City State ZIP Code

Same as Billing Address

Check this box if the Subject Property Address is the same as the Billing Address

Subject Property Address:(Required)

Street Address City State / Province / Region ZIP / Postal Code Country

Applicant Signature(Required)

Please Sign

Comments

This field is for validation purposes and should be left unchanged.

Borrower Acknowledgment

I/We authorize Prime Choice Funding Inc to charge my/our card for the credit report fee stated above.
I/We authorize Prime Choice Funding Inc. to obtain and review my/our credit report(s) through Informative Research or Xactus, its third-party credit reporting vendor.
I/We acknowledge that I/we am/are responsible for this fee regardless of loan approval or denial.
I/We understand that this is a non-refundable fee once the credit report has been ordered.
I/We understand this authorization does not constitute a loan approval.

Cardholder information will be securely processed and will not be retained outside of Prime Choice Funding Inc’s secure credit vendor system.