CADirect Order Page

Credit Analysis

Borrower Info:
First Name *	Middle Name	Last Name *	Suffix

Birth Month *	Day *	Year *

Coborrower Info: (if married only)
First Name *	Middle Name	Last Name *	Suffix

Birth Month *	Day *	Year *

Current Address:
Street Address *
City *	State *	Zip *

Length Of Time At This Address
2 Years Or More Less Than 2 Years

Available Cash for Credit Improvement *
$

Credit Card Billing Information

You must use your own credit card with your name (as specified above) on it.

Same address as above

Street Address *
City *	State *	Zip *

Card Number *

CVV *

Expiration Mo*

Year *

Additional Information For Borrower

Phone Number *

Email Address *

Previous Street Address *
City *	State *	Zip *

Authorization Agreement

I hereby authorize ECI FINANCIAL CORPORTATION to verify my past and present employment earnings records, bank accounts, stockholdings, and any other asset balances that are needed to process my mortgage loan application. I further authorize ECI FINANCIAL CORPORTATION to order a consumer credit report and verify other credit information, including past and present mortgages and landlord references.

ECI FINANCIAL CORPORTATION may also utilize the services of CERTIFIED CREDIT LINK to further verify my personal credit information and the information ECI FINANCIAL CORPORTATION obtains is only to be used in the processing of my application for a mortgage loan. It is understood that a copy of this form will also serve as authorization. This authorization expires 120 days from the date indicated below.

Privacy Act Notice: This information is to be used by the agency collecting it or its assignees in determining whether you qualify as a prospective mortgagor under its program. It will not be disclosed outside the agency except as required and permitted by law. You do not have to provide this information, but if you do not your application for approval as a prospective mortgagor or borrower may be delayed or rejected. The information requested in this form is authorized by Title 38, USC, Chapter 37 (if VA); by 12 USC, Section 1701 et. seq. (if HUD/FHA); by 42 USC, Section 1452b (if HUD/CPD); and Title 42 USC, 1471 et. seq., or 7 USC, 1921 et. seq. (if USDA/FmHA).

I hereby certify that I am eighteen years of age or older and that I am the person identified herein. I understand that any person who knowingly and willfully obtains information on a consumer from a consumer reporting agency under false pretenses shall be subject to a fine, imprisonment, or both.

By typing my Social Security Number in the box below, I hereby authorize ECI FINANCIAL CORPORTATION to pull a credit report on me.

Borrower SSN	*
Coborrower SSN	*