Voluntary Government Monitoring Information
APPLICABLE ONLY TO HOME IMPROVEMENT/PURCHASE TRANSACTIONS AND DWELLING REFINANCES
(Not applicable to HELOCS)
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. The law provides
that a lender may discriminate neither on the basis of this information, nor on
whether you choose to furnish it. If you furnish the information, please provide
both ethnicity and race. For race, you may check more than one designation. If you
do not furnish ethnicity, race, or sex, under Federal regulations, this lender is
required to note the information on the basis of visual observation or surnames.
If you do not wish to furnish the information, please choose the selection below.
Applicant
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Co-Applicant ( If applicable )
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