CLIENT INFORMATION FORM / AGREEMENT – LOAN OFFICER
NOTICE TO USERS OF CONSUMER REPORTS. Congress has limited the use of consumer reports to protect consumers' privacy. All users must have a permissible purpose under the FCRA to obtain a consumer report. FCRA, 15 U.S.C. §§ 1681 et seq. Section 604 of the FCRA contains a list of the permissible purposes under the law.
Broker Name (Your Employer)
Note:Please attach a copy of your Mortgage Loan Officer License. AlsoCredit Information Systems must have an agreement in place with your Broker and you must notify us immediately if you leave or change employers.
Name SSN--
Email Address
Home Address
City State Zip
Home Telephone () Cell Phone ()
Supervisor’s Name Office: Telephone () Fax()
LO license obtained on Issuing State License No.
Do you or your employer do any Credit Repair?Yes No
My Bank Branch
Telephone() Checking Account Number
Permissible Purpose for Credit Reports:
As a Client of Credit Information Systems, I hereby authorize and give my consent to Credit Information Systems to secure a credit report and agree to the releases of credit information and to obtain any and all information concerning my business and/or personal history and financial credit which Credit Information Systems may require from time to time in connection with this Agreement. I further agree and authorize Credit Information Systems to obtain all information, including credit information, contained in my creditors’ files. This authorization shall be continuing without expiration and a photocopy or fax copy shall be given the same effect as the original.
All terms and conditions stated on pages 2-4 and Exhibits are part of this agreement and are incorporated herein. Please read them carefully before signing.
Dated this day of, 20
Client Name (Print) Signature______
WITHOUT SIGNING AND DATING, THIS APPLICATION CANNOT BE PROCESSED!
NOTICE
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 applicants 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 creditor is the Federal Trade Commission.
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CLIENT INFORMATION FORM/AGREEMENT- LOAN OFFICER
Information. Credit Information Systems will provide to Client products or services (Information), subject to the terms and conditions of this Agreementand the terms of a similar agreement entered into between Credit Information Systems and Client’s Broker/Employer,which agreement is incorporated herein by reference, and applicable law. Credit Information Systems will use good faith efforts to obtain and assemble the requested Information from reliable sources but does not guarantee the accuracy of any Information reported. Client will not resell the Information, or related reports, or the contents of the Information, or reports obtained as a result of this Client Agreement.THE INFORMATION IS PROVIDED "AS IS" WITHOUT ANY EXPRESS OR IMPLIED WARRANTY OF ANY KIND INCLUDING WARRANTIES OF MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE, NON-INFRINGEMENT AND IMPLIED WARRANTIES ARISING FROM COURSE OF DEALING OR COURSE OF PERFORMANCE.
Payment Terms and Pricing. Client will be billed monthly for services requested, Payments are to be delivered to Credit Information Systems, according to the terms agreed upon in Exhibit A. The charges for said services will be at Credit Information Systems' standard rates, as may be periodically adjusted with thirty days notice, unless specifically agreed to in writing in advance by Credit Information Systems. Client agrees to pay accrued charges within 20 days of the statement/invoice date. Credit Information Systems may terminate services without further notice or liability if the balance due is not timely paid. An additional 1.5% per month interest charge will be charged on all amounts not paid within 20 days after due date, both before and after judgment, and continue each month until paid in full. In the event of default, the undersigned agrees to pay all costs of collection, including collection agency fees and attorneys' fees whether hourly or contingent, but not to be less than 33 1/3% of the amount due if contingent, together with costs of court. Client further agrees that any legal action may be brought in Salt Lake County, Utah or Pottawattamie County, Iowa, at Credit Information Systems' discretion.
Term; Termination. This Agreement will remain in force and in effect for one year, and thereafter from year-to-year, on the same basis as set forth herein. If Client is delinquent in any payment provided for herein, or is in violation of the FCRA, or has breached any term of this Agreement, or there is a material change in any law or regulation which adversely affects this Agreement, or upon expiration or termination of Credit Information Systems' agreement with the source of the Information, Credit Information Systems will have an unrestricted right, without prior notice, to forthwith terminate this Agreement without any liability whatsoever to Client. Credit information Systems reserves the right to terminate this Agreement for any reason, effective upon 30-days written notice to Client.
Client's Compliance with Laws and FCRA Representations. Client will conduct itself and use the Information in compliance with all international, federal, state and local laws, regulations and orders as may be applicable. Client shall not access or transmit technical or other data outside of the United States. In addition to the agreements and representations made elsewhere in this Client Agreement, Client represents that it is knowledgeable of and will comply with all applicable provisions of the Fair Credit Reporting Act (FCRA), 15 U.S.C. §§1681 et seq. and all other applicable statutes, both federal and state, and in connection therewith, acknowledges and agrees that (i) the "Obligations of Users Under the FCRA" Exhibit C is incorporated herein and is hereby made an integral part of the Client Agreement. Client further warrants that it has a "permissible purpose" under the FCRA to obtain the Information derived from the Fair Isaac Credit Scoring Model ("Scores"), and Client will request Scores for Client's exclusive use.
Client Responsibilities and Certifications. Client will comply with the applicable provisions of the FCRA, Federal Equal Credit Opportunity, the Safeguards Rule,Gramm-Leach-Bliley Act,and will comply with the "Disposal of Consumer Report Information and Records" and any amendments to them, all applicable state law counterparts, and all applicable regulations promulgated under any of them including, without limitation, any provisions requiring adverse action notification to the consumer. Client will not alter or permit a third party to alter any Information received from Credit Information Systems.
Access Security Requirements. FCRA provides that any person who knowingly and willfully obtains information on a consumer from a consumer reporting agency under false pretenses shall be fined under Title 18 of the United States Code, or imprisoned not more than two years, or both. Clientacknowledges that the "Access Security Requirements" (Exhibit B) is incorporated herein and is hereby made an integral part of the Client Agreement. Credit Information Systems reserves the right to modify the "Access Security Requirements" at its sole discretion.
Force Majeure.Client Information Systems shall not be liable to Clientfor any delay or failure in performance of any part of this Agreement if such is caused by an unforeseeable event beyond the reasonable control of the party, commonly referred to as acts of God.
Indemnification. Client shall indemnify, defend, and hold harmless Credit Information Systems,its employees, directors, officers, affiliates, and agents against any claim, suit, action, liability, costs, and expenses, including any proceeding brought by a third party to the extent that such Claim is based on or arises from the breach of any representation, warranty, or covenant of Client.
Governing Law; Attorneys' Fees.This Agreementwill be governed by the laws of the State of Utah and venue shall be in Salt Lake County, Utah. In the event of any default on the part of either party to this Agreement, in addition to all other remedies, the party in default will pay the aggrieved party all amounts due and all damages, costs and expenses, including reasonable attorneys' fees, incurred by the aggrieved party in any legal action, arbitration or other proceeding as a result of such default, plus interest at the highest rate allowable by law, accruing from the date of such default.
Severability. If any provision of this Agreement or the application of any provision to any person or to any circumstances shall be determined to be invalid or unenforceable, then such determination shall not affect any other provision of the Client Agreement or the application of such provision to any other person or circumstance, all of which other provisions shall remain in full force and effect.
Amendment; Assignment.All amendments to this Agreement shall be in writing and signed by the parties.Client shall not assign, sell or transfer its rights in this Agreement whether by operation of law or otherwise. This Agreement is fully assignable by Credit Information Systems and shall inure to the benefit of any assignee or other legal successor in interest. Credit Information Systems also reserves the right to delegate any or all of its duties arising hereunder.
EXHIBIT A
PAYMENT OPTIONS
AUTOMATIC CREDIT CARD OR EFT AUTHORIZATION
I hereby authorize Credit Information Systems to charge the following credit card / checking account for charges incurred by with Credit Information Systems as follows:
One time in the amount of $.
With each transaction in the amount of the transaction.
On a monthly basis for the amount of all transactions during the month.
Account to be charged on the day of each month for the prior month's charges.
For all balances not paid within thirty (30) days of the statement/invoice date.
Please charge the following credit card:
VisaTMMasterCardTM American Express TM
Name on Card
Card # Control # Expiration Date
Please charge the following checking account:
Bank Routing Number
Bank Checking Account Number
Name on the Checking Account
Payment will be remitted by check within 20 days of invoicing to:
Credit Information Systems, P 0 Box 186 Council Bluffs, Iowa 51502
NOTE: Credit Information Systems may immediately terminate the related account or otherwise put the account on hold, at Credit Information Systems' election and without liability to user, if the credit card or EFT transfer is declined.
Date:
Name Signature ______
City State Zip
EXHIBITB
ACCESS SECURITY REQUIREMENTS
We must work together to protect the privacy of consumers. The following measures are designed to reduce the unauthorized access of consumer reports. By signing this document you agree as follows:
- You must protect your Consumer Reporting Agency account access number and password so that only key personnel know this sensitive information. Unauthorized persons should never have knowledge of your password. Do not post the information in any manner within your facility.
- System access software, whether developed by your company or purchased from a third party vendor, must have your Consumer Reporting Agency account number and password hidden or embedded and be known only by supervisory personnel.
- Do not discuss your Consumer Reporting Agency account number and passwords by telephone with any unknown caller, even if the caller claims to be an employee of the Consumer Reporting Agency.
- Restrict the ability to obtain credit information to a few key personnel only.
- Place all terminal devices used to obtain credit information in a secure location within your facility. You should secure these devices so that unauthorized persons cannot easily access them.
- After normal business hours, turn off and lock all devices/ systems used to obtain credit information.
- Secure hard copies and electronic files of consumer reports within your facility so that unauthorized persons cannot easily access them.
- Cross-shred, burn or pulverize all hard copy consumer reports when no longer needed.
- Erase or scramble electronic files containing consumer information when no longer needed and when applicable regulations permit destruction.
- Make all employees aware that your company can access credit information only for permissible purposes listed in the permissible purpose information section of your application. YOUR EMPLOYEES MAY NOT ACCESS THEIR OWN REPORT OR THE REPORT OF A FAMILY MEMBER OR FRIEND if your company does not have permissible purpose for that report. THE REPORT(S) IS(ARE) NOT TO BE USED IN CONJUNCTION WITH ANY CREDIT REPAIR AGENCY.
Record Retention: It is important that you keep the credit application signature for a reasonable period of time. This will facilitate the investigative process if a consumer claims that your company inappropriately accessed his/her credit report. The Federal Equal Credit Opportunity Act states that a credit file must preserve all written or recorded information connected with an application for 25 months.When conducting an investigation, particularly following a breach or a consumer complaint that your company impermissibly accessed their credit report, the credit reporting agency will contact you and will request a copy of the original application signed by the consumer or, if applicable, a copy of the sales contract. I hereby state that I will comply with the above provisions and the FCRA and understand that under section 621 (a) (2) (A) of the FCRA, "any person that violates any of the provisions of the FCRA may be liable for a civil penalty of not more than $3,500 per violation"
Date:
Signature: ______Print Name:
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EXHIBIT C
Part III
16 CFR Part 601
Notices of Rights and Duties Under the Fair Credit Reporting Act; Rule Appendix C to Part 601-- Prescribed Notice of Users Responsibilities This appendix prescribes the content of the required notice.
NOTICE TO USERS OF CONSUMER REPORTS: OBLIGATIONS OF USERS UNDER THE FCRA
The federal Fair Credit Reporting Act (FCRA) requires that this notice be provided to inform users of consumer reports of their legal obligations. State Law may impose additional requirements. This first section of this summary sets forth the responsibilities imposed by the FCRA on all users of consumer reports. The subsequent sections discuss the duties of users of reports that contain specific types of information, or that are used for certain purposes, and the legal consequences of violations. The FCRA, 15 U.S.C. §§1681-1681u, is set forth in full at the Consumer Financial Protection Bureau's Internet web site(
I. OBLIGATIONS OF ALL USERS OF CONSUMER REPORTS
A. Users Must Have a Permissible Purpose
Congress has limited the use of consumer reports to protect consumers' privacy. All users must have a permissible purpose under the FCRA to obtain a consumer report. Section 604 of the FCRA contains a list of the permissible purposes under the law. These are:
As ordered by a court or a federal grand jury subpoena. Section 604(a) (1)
As instructed by the consumer in writing. Section 604(a)(2)
For the extension of credit as a result of an application from a consumer, or the review or collection of a consumer's account. Section 604(a)(3) (A)
For employment purposes, including hiring and promotion decisions, where the consumer has given written permission. Sections 604(a)(3)(B) and 604(b)
For the underwriting of insurance as a result of an application from a consumer. Section 604(a)(3)(C)
When there is a legitimate business need, in connection with a business transaction that is initiated by the consumer. Section 604(a)(3)(F)(i)
To review a consumer's account to determine whether the consumer continues to meet the terms of the account. Section 604(a)(3)(F)(ii)
To determine a consumer's eligibility for a license or other benefit granted by a governmental instrumentality required by law to consider an applicant's financial responsibility or status. Section 604(a)(3)(D)
For use by a potential investor or servicer, or current insurer, in a valuation or assessment of the credit or prepayment risks associated with an existing credit obligation. Section 604(a)(3)(E)
For use by state and local officials in connection with the determination of child support payments, or modifications and enforcement thereof. Sections 604(a)(4) and 604(a)(5)
In addition, creditors and insurers may obtain certain consumer report information for the purpose of making unsolicited offers of credit or insurance. The particular obligations of users of the "prescreened" information are described in Section VII below.
- Users Must Provide Certifications
Section 604(f) of the FCRA prohibits any person from obtaining a consumer report from a consumer reporting agency (CRA) unless the person has certified to the CRA (by general or specific certification, as appropriate) the permissible purpose(s) for which the report is being obtained and certifies that the report will not be used for any other purpose.
- Users Must Notify Consumers When Adverse Actions Are Taken
The term "adverse action" is defined very broadly by Section 603 of the FCRA. "Adverse actions" include all business, credit, and employment actions affecting consumers that can be considered to have a negative impact such as unfavorably changing credit or contract terms or conditions, denying or canceling credit or insurance, offering credit on less favorable terms than requested, or denying employment or promotion.
1. Adverse Actions Based on Information Obtained From a CRA
If a user takes any type of adverse action that is based at least in part on information contained in a consumer report, the user is required by Section 615(a) of the FCRA to notify the consumer. The notification may be done in writing, orally, or by electronic means. It must include the following:
The name, address, and telephone number of the CRA (including a toll-free telephone number, if it is a nationwide CRA) that provided the report.