EQUAL OPPORTUNITY DATA COLLECTION FORM

THE FOLLOWING INFORMATION IS REQUESTED BY THE FEDERAL GOVERNMENT FOR CERTAIN TYPES OF LOANS IN ORDER TO MONITOR COMPLIANCE WITH EQUAL OPPORTUNITY. YOU ARE NOT REQUIRED TO FURNISH THIS INFORMATION BUT ARE ENCOURAGED TO DO SO. THE LAW REQUIRES THAT WE NEITHER DISCRIMINATE ON THE BASIS OF THIS INFORMATION NOR ON WHETHER YOU CHOOSE TO FURNISH IT. IF YOU CHOOSE NOT TO FURNISH IT FEDERAL REGULATIONS REQUIRE US TO NOTE RACE/ETHNICITY ON THE BASIS OF VISUAL OBSERVATION OR SURNAME. IF YOU DO NOT WISH TO FURNISH THE INFORMATION PLEASE CHECK THE BOX BELOW.