Investor Registration Form
Lender & Vesting
Full Name of Lending Entity(to hold title)
*
Tax I.D # or Social Security #
*
Title to be held as:
*
(i.e. Husband and Wife as Joint Tenants, Community Property, Married Sole and Separate, A single Man or Woman, A Corporation, Trust)
Investor Name
*
First Name
Middle Initial
Last Name
Date of Birth:
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Title:
If Corporation, Partnership, Trust, or Company
Co-Investor Name
First Name
Middle Initial
Last Name
Date of Birth:
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Title:
If Corporation, Partnership, Trust, or Company
FOR TRUSTS (Provide a Copy of the Trust Agreement) FOR CORPORATIONS (Provide Articles & Minutes Naming Officers/Signers)
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Mailing Address
*
Street Address
Street Address Line 2
City
Please 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
State
Zip Code
Contact and Telephone Information
Investor Primary/Cell
*
Format: (000) 000-0000.
Business
Format: (000) 000-0000.
Co-Investor Primary/Cell
Format: (000) 000-0000.
Business
Format: (000) 000-0000.
Fax
Format: (000) 000-0000.
Investor E-Mail:(Required for Digital Signatures, Online Access and Communication)
example@example.com
Co-Investor E-Mail: (Required for Digital Signatures, Online Access and Communication)
example@example.com
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How do you prefer to receive interest payments?
Check
Direct Depoist
Interest payments by check
Name check payable to:
Address to Send Checks
Street Address
City
Please 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
State
Zip Code
Automatic Deposit Information
Routing Number #
(please verify your routing number with your the bank as it may be different from a deposit ticket or check)
Account Number #
Account Type (please check one)
Checking
Savings
Name on Account
Online Access to your Investment Portfolio is available by request only, please check one:
*
Yes
No
Servicing Agreements - Preferred Method of Signing
Please select how you would prefer to sign Servicing Agreements and Disclosures (one document per loan you are invested in). Please "X" one option
Digital Signing (electronic signature)
Email (investor will need to return via email/fax/in office)
Mail (including return envelope with paid postage)
Sign in Person (front desk will call when available)
Would you like to receive a copy of these servicing agreements after signing? please check one:
Yes
No
These options can be changed at any time. If there are any questions or concerns with servicing agreements and disclosures, please don't hesitate to call the front desk at (559) 432-8221
New Investor Signature
Investor Signature:
*
Date
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Co- Investor Signature:
Date
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
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