1 Contact Info 2 Loan Information 3 Applicant Information 4 Employment Information 5 Co-Applicant Information 6 Co-Applicant Employment Information 7 Current Assets 8 Outstanding Debts 9 Other Obligations 10 Applicant Government Monitoring Information 11 Co-Applicant Government Monitoring Information 12 Signers 13 Privacy Policy How can we contact you? Let's start with a little information about you. First Name * Required Middle Name Required Last Name * Required Email Address * Required Confirm Email Address * Required Phone Number *Required By providing the phone number, you are opting in to receive SMS updates regarding your documents and transaction status. Epic River does not charge for SMS messaging; however, message & data rates may apply. Contact your mobile carrier for information. Loan Information Please provide all relevant information. Amount * Required $ Loan Purpose Required Select Consumer Business Financing Type * Required Select Home Equity Purchase Real Estate Refinance Real Estate Proceeds of Credit to Be Used For. * Required Type of Credit Applying For * Required Select Individual Credit Joint Credit Property Type * Required Select Primary Residence Secondary Residence Investment Property Address of Property to be used as Collateral for Loan Request * Required Applicant Information Please provide all relevant information. Date of Birth * Required Social Security Number * Required Present Address Line 1 * Required Present Address Line 2 Required Present Address City * Required Present Address State * Required Select Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Present address Zip * Required Do you own or rent your current residence? * Required Select Own Rent How many years have you lived at your current residence? * Required Previous Address * Required Did you own or rent your previous residence? * Required Select Own Rent How many years did you live at your previous residence? * Required Marital Status * Required Select Married Separated Unmarried (including single, divorced, widowed) Nearest Relative (Not Living With You) Required Nearest Relative Phone Number Required Please list any additional information or explanations here: Required Employment Information Please enter your employment infomation Name of Employer * Required Address of Employer Required Manager Required Phone Number Required Gross Monthly Income * Required $ Position/Title Required Employment Status * Required Select Full-Time Part-Time Self Employment Number of Years on the Job * Required Previous Employer * Required Address of Previous Employer Required Previous Manager Required Phone Number of Previous Employer Required Previous Gross Monthly Income Required $ Previous Position/Title Required Number of Years on the Job * Required Do you have more than one form of employment? Required Select Yes No Name of Additional Employer * Required Address of Employer Required Manager Required Phone Number Required Gross Monthly Income * Required $ Position/Title Required Employment Status Required Select Full-Time Part-Time Self-Employment Number of Years on the Job Required Alimony, Child Support, Separate Maintenance Payments: You are not required , to disclose income from alimony, child support, or separate maintenance payments, However, if you are relying on income from alimony, child support, or separate maintenance payments as a basis for repayment of this obligation, please enter the monthly amount in the Other Income field. Required Select Court Order Written Agreement Oral Understanding N/A If you earn any other income monthly, please list the amount. Required $ Where do you receive this income from? Required Is any income (ie, Assets, Employment, Other Income) likely to be reduced before the credit is paid off? Required Select Yes No If answered yes to the previous question, please explain Required Co-Applicant Information Please provide all relevant information. Date of Birth * Required Social Security Number * Required Present Address Line 1 * Required Present Address Line 2 Required Present Address City * Required Present Address State * Required Select Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Present Address Zip * Required Do you own or rent your current residence? * Required Select Own Rent How many years have you lived at your current residence? * Required Previous Address * Required Did you own or rent your previous residence? Required Select Own Rent How many years did you live at your previous residence? * Required Marital Status * Required Select Married Separated Unmarried (including single, divorced, widowed) Co-Applicant Employment Information Please enter your employment infomation Name of Employer * Required Address of Employer Required Manager Required Phone Number Required Gross Monthly Income * Required $ Position/Title Required Employment Status * Required Select Full-Time Part-Time Self-Employed Retired Unemployed Number of Years on the Job Required Previous Employer? * Required Address of Previous Employer Required Previous Manager Required Previous Position Phone Number of Previous Employer Required Previous Gross Monthly Income Required $ Previous Position/Title Required Number of Years on the Job Required Do you have more than one form of employment? Required Select Yes No Name of Additional Employer * Required Address of Employer Required Manager Required Phone Number Required Gross Monthly Income * Required $ Position/Title Required Employment Status Required Select Full-Time Part-Time Self-Employed Number of Years on the Job Required Alimony, Child Support, Separate Maintenance Payments: You are not required , to disclose income from alimony, child support, or separate maintenance payments, However, if you are relying on income from alimony, child support, or separate maintenance payments as a basis for repayment of this obligation, please enter the monthly amount in the Other Income field. Required Select Court Order Written Agreement Oral Understanding N/A If you earn any other income monthly, please list the amount. Required $ Where do you receive this income from? Required Is any income (ie, Assets, Employment, Other Income) likely to be reduced before the credit is paid off? Required Select Yes No If answered yes to the previous question, please explain Required Current Assets If the "Joint Applicant" or "Other Party" Sections were completed, this Section should be completed by giving information about both the Applicant and the Joint Applicant or Other Party, if applicable Type or Description of Asset Required Current Market Value Required $ Remaining Balance of Lien Required $ Asset Owner's Name Required 2. Type or Description of Asset Required Current Market Value Required $ Remaining Balance of Lien Required $ Asset Owner's Name Required 3. Type or Description of Asset Required Current Market Value Required $ Remaining Balance of Lien Required $ Asset Owner's Name Required 4. Type or Description of Asset Required Current Market Value Required $ Remaining Balance of Lien Required $ Asset Owner's Name Required 5. Type or Description of Asset Required Current Market Value Required $ Remaining Balance of Lien Required $ Asset Owner's Name Required 6. Type or Description of Asset Required Current Market Value Required $ Remaining Balance of Lien Required $ Asset Owner's Name Required 7. Type or Description of Asset Required Current Market Value Required $ Remaining Balance of Lien Required $ Asset Owner's Name Required 8. Type or Description of Asset Required Current Market Value Required $ Remaining Balance of Lien Required $ Asset Owner's Name Required 9. Type or Description of Asset Required Current Market Value Required $ Remaining Balance of Lien Required $ Asset Owner's Name Required 10. Type or Description of Asset Required Current Market Value Required $ Remaining Balance of Lien Required $ Asset Owner's Name Required 11. Type or Description of Asset Required Current Market Value Required $ Remaining Balance of Lien Required $ Asset Owner's Name Required 12. Type or Description of Asset Required Current Market Value Required $ Remaining Balance of Lien Required $ Asset Owner's Name Required Outstanding Debts Include loans, charge accounts, installment contracts, credit cards, mortgages, rents, and other obligations If you rent, who is your landlord? Required Monthly Rent Payment Required $ If you own your home, who is your Mortgage/Lien Holder? Required Type of Debt or Account Number Required Current Balance Required $ Monthly Payment Required $ 1. Creditor Name Required Type of Debt or Account Number Required Current Balance Required $ Monthly Payment Required $ 2. Creditor Name Required Type of Debt or Account Number Required Current Balance Required $ Monthly Payment Required $ 3. Creditor Name Required Type of Debt or Account Number Required Current Balance Required $ Monthly Payment Required $ 4. Creditor Name Required Type of Debt or Account Number Required Current Balance Required $ Monthly Payment Required $ 5. Creditor Name Required Type of Debt or Account Number Required Current Balance Required $ Monthly Payment Required $ 6. Creditor Name Required Type of Debt or Account Number Required Current Balance Required $ Monthly Payment Required $ 7. Creditor Name Required Type of Debt or Account Number Required Current Balance Required $ Monthly Payment Required $ 8. Creditor Name Required Type of Debt or Account Number Required Current Balance Required $ Monthly Payment Required $ 9. Creditor Name Required Type of Debt or Account Number Required Current Balance Required $ Monthly Payment Required $ Please List Any Credit Reference: Credit Reference Name (If Needed). Required Credit Reference Name (If Needed). Required Credit Reference Name (If Needed). Required Other Obligations Please answer to the best of your ability. Are you a co-maker, endorser, co-signer, surety, or guarantor on any loan, contract or other obligations? * Required Select Yes No Amount Required $ For Whom? Required To Whom? Required Are there any unsatisfied judgements against you? * Required Select Yes No Amount per month Required $ To whom? Required Have you been declared bankrupt in the last 10 years? * Required Select Yes No Where (State)? Required Select AL AK AZ AR CA CO CT DC DE FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY Year Required Are you obligated to make Alimony, Support, or Maintenance Payments? * Required Select Yes No Amount per month Required $ To whom Required Co-Applicant: Are you a co-maker, endorser, co-signer, surety, or guarantor on any loan, contract or other obligations? * Required Select Yes No Co-Applicant: Amount Required $ Co-Applicant: For Whom? Required Co-Applicant: To Whom? Required Co-Applicant: Are there any unsatisfied judgements against you? * Required Select Yes No Co-Applicant: Amount per month Required $ Co-Applicant: To whom? Required Co-Applicant: Have you been declared bankrupt in the last 10 years? * Required Select Yes No Co-Applicant: Where (State)? Required Select AL AK AZ AR CA CO CT DC DE FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY Co-Applicant: Year Required Co-Applicant: Are you obligated to make Alimony, Support, or Maintenance Payments? * Required Select Yes No Co-Applicant: Amount per month Required $ Co-Applicant: To whom Required Applicant Government Monitoring Information Please answer all the questions. Ethnicity Required Select Hispanic or Latino Not Hispanic or Latino I do not wish to provide that information Mexican Required Select Y N Puerto Rican Required Select Y N Cuban Required Select Y N Other Hispanic or Latino - Print origin, for example, Argentinean, Colombian, Dominican, Nicaraguan, Salvadoran, Spaniard, and so on: Required Do you wish to provide Race Information ? Required Select Y N American Indian or Alaskan Native - Print name of enrolled or principal tribe: Required Asian Required Select Y N Asian Indian Required Select Y N Chinese Required Select Y N Filipino Required Select Y N Japanese Required Select Y N Korean Required Select Y N Vietnamese Required Select Y N Other Asian - Print race, for example, Hmong, Laotian, Thai, Pakistani, Cambodian, and so on: Required Black or African American Required Select Y N Native Hawaiian or Other Pacific Islander Required Select Y N Native Hawaiian Required Select Y N Guamanian or Chamorro Required Select Y N Samoan Required Select Y N Other Pacific Islander - Print race, for example, Fijian, Tongan, and so on: Required White Required Select Y N sex Required Select Male Female I do not wish to provide that information Co-Applicant Government Monitoring Information Select Next if there is no Co-Applicant Ethnicity Required Select Hispanic or Latino Not Hispanic or Latino I do not wish to provide that information Mexican Required Select Y N Puerto Rican Required Select Y N Cuban Required Select Y N Other Hispanic or Latino - Print origin, for example, Argentinean, Colombian, Dominican, Nicaraguan, Salvadoran, Spaniard, and so on: Required Select Y N Do you wish to provide Race Information ? Required Select Y N American Indian or Alaskan Native - Print name of enrolled or principal tribe: Required Asian Required Select Y N Asian Indian Required Select Y N Chinese Required Select Y N Filipino Required Select Y N Japanese Required Select Y N Korean Required Select Y N Vietnamese Required Select Y N Other Asian - Print race, for example, Hmong, Laotian, Thai, Pakistani, Cambodian, and so on: Required Black or African American Required Select Y N Native Hawaiian or Other Pacific Islander Required Select Y N Native Hawaiian Required Select Y N Guamanian or Chamorro Required Select Y N Samoan Required Select Y N Other Pacific Islander - Print race, for example, Fijian, Tongan, and so on: Required White Required Select Y N sex Required Select Male Female I do not wish to provide that information Additional Signers Create and assign signers for signature roles. Add Signer Borrower * Required Select a signer None/Not Applicable CO-Borrower * Required Select a signer None/Not Applicable All Signers Privacy Policy Please read and accept the privacy policy to continue. Accept Privacy Policy You're done! Thank you for completing your application! You can now begin signing your closing documents. Thank you for completing your application!Your financial institution is reviewing your application and will contact you for the next steps.You can now safely close your browser window or tab. Thank you for your submission! Your financial institution will contact you for the next steps.You can now safely close your browser window or tab. © Copyright 2025 Epic River Financial, Inc. All rights reserved. Version 25.1.0.17