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Home > Regulation & Examinations > Bank Examinations > Side by Side: A Guide to Fair Lending |
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Side by Side: A Guide to Fair Lending |
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APPENDIX A: TESTER IDENTITY Personal Information: Name:_____________________________________________________________________ Race:_____________________ Age:_____________________ Sex:_____________________ Current Address: ___________________________________________________________________ Marital Status:______________________________ How Long:_____________________ Spouse's Name:____________________________ Age:__________________________ Number of Children:__________________________ Names/Ages: _______________________________________________________________ Years at Current Address: _____________________________________________________ Rent Amount: _______________________________________________________________ Previous Address: ___________________________________________________________ Years at Previous Address: ____________________________________________________ Rent Amount: _______________________________________________________________ Employment Information: Employer: _________________________________________________________________ Occupation: ________________________________________________________________ Address of Employer:_________________________________________________________ __________________________________________________________________________ Length of Employment: _______________________________________________________ Monthly Gross Income: _______________________________________________________ Annual Gross Income ________________________________________________________ Monthly Net Income: _________________________________________________________ Previous Employer: __________________________________________________________ Occupation: ________________________________________________________________ Length of Employment: _______________________________________________________ Monthly Gross Income: _______________________________________________________ Annual Gross Income: ________________________________________________________ Monthly Net Income: _________________________________________________________ Spouse's Employer: __________________________________________________________ Occupation: ________________________________________________________________ Length of Employment: _______________________________________________________ Monthly Gross Income: _______________________________________________________ Annual Gross Income: ________________________________________________________ Monthly Net Income: _________________________________________________________ Spouse's Previous Employer: __________________________________________________ Occupation: ________________________________________________________________ Length of Employment: _______________________________________________________ Monthly Gross Income: _______________________________________________________ Annual Gross Income: ________________________________________________________ Monthly Net Income: _________________________________________________________ Total Annual Household Income:______________ Gross:___________________________________ Net:_____________________________________ Credit Information: Charge Card(s): Balance Monthly Payment (1)______________________ ______________________ ______________________ (2)______________________ ______________________ ______________________ (3)______________________ ______________________ ______________________ Loan(s): Balance Monthly Payment (1)______________________ ______________________ ______________________ (2)______________________ ______________________ ______________________ (3)______________________ ______________________ ______________________ Other Financial Information: Savings: ___________________________________________________________________ Amount: ___________________________________________________________________ Checking: __________________________________________________________________ Amount: ___________________________________________________________________ Other: _____________________________________________________________________ Housing Information: Neighborhood/House Location__________________________________________________ Address: ___________________________________________________________________ Size/# Bedrooms: ____________________________________________________________ Style: _____________________________________________________________________ Age:___________ CAC:___________ Garage Type:___________ Taxes:___________ Sales Price: ________________________________________________________________ Closing Date: _______________________________________________________________ Down payment: _____________________________________________________________ Source: ____________________________________________________________________ Other closing costs: __________________________________________________________ Source: ____________________________________________________________________ Information about the Financial Institution: Name:_____________________________________________________________________ Address: ___________________________________________________________________ Phone: ____________________________________________________________________ Hours:_____________________________________________________________________ How you found this office: _____________________________________________________ Miscellaneous:
Other Instructions: ________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ |
| Last Updated 07/28/1999 | dcainternet@fdic.gov |
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