[A] $0 - 5,000 [B] $5,001 - 10,000 [C] $10,001 - 15,000 [D] $15,001 - 25,000 [E] Over $25,000 4. [A] $0 - 5,000 [B] $5,001 - 10,000 [C] $10,001 - 20,000 [D] $20,001 - 35,000 COMBINED MONTHLY DEBT PAYMENTS. [A] $0 - 100 [B] $101 - 200 [C] $201 - 300 [D] $301 - 500 [E] $501 - 800 [E] Over $35,000 [F] Over $800 [A] $0-5,000 [B] $5,001 - 10,000 [C] $10,001 - 20,000 [D] $20,001 - 30,000 [E] $30,001 - 60,000 [F] $60,001 - 100,000 [G] Over $100,000 6. AMOUNT OF LOAN REQUESTED: [A] $0 -2,500 [B] $2,501 - 5,000 [C] $5,001 - 10,00. [D] $10,00115,000 7. [E] $15,001 - 25,000 [F] $25,001 - 35,000 [G] $35,001 - 45,000 [H] $45,001 - 60,000 [I] $60,001 - 75,000 [J] Over $75,000 PURCHASE PRICE OF SUBJECT PROPERTY. [A] $0 - 5,000 [B] $5,001 10,000 [C] $10,001 20,000 [D] $20,001 - 30,000 [E] $30,001 50,000 [F] $50,001 75,000 [G] Over $75,000 The Federal Government, not this lending insitution, asks you to provide the following information as part of its program to assure equal treatment of all citizens under the Civil Rights Act of 1968. Federal law prohibits this institution from denying a housing loan or discriminating in the amount, interest rate, duration, or other terms of the loan because of the applicant's race, color, religion or national origin. 1. Please circle the lettered box below which you believe best describes your ethnic identification. ("Spanish Descent" includes persons of Puerto Rican, Cuban, Mexican and Central and South American descent.) [A] American Indian [B] Asian [C] Black/Negro [D] Spanish Descent [E] White/Caucasian 2 MARITAL STATUS [F] Other (Circle the appropriate lettered box.) [A] Single [B] Married [C] Divorced [D] Widowed 3 SEX (Circle the appropriate lettered box.) [A] Male [B] Female Part III. DENIAL OR FAILURE TO SUBMIT (To be filled in by institution only if loan is denied or if written application is not submitted.) (a) Date of denial by institution if written application has been submitted: (b) Reasons for decision or for failure to submit written application U.S.C. 1981, 1982); E.O. 11063, 27 FR 527; sec 17, 47 Stat. 736, as amended, sec. 5, 48 Stat. 132, as amended (12 U.S.C. 1464)) [39 FR 12110, Apr. 3, 1974, as amended at 39 FR 18642, May 29, 1974; 39 FR 27121, Juy 25, 1974; 40 FR 27477, June 30, 1975] (Title VIII, Pub. L. 90-284, 82 Stat. 81 (42 U.S.C. 3601-3619); 16 Stat. 144, 14 Stat. 27 (42 § 528.7 Nondiscrimination in employ ment. (a) No member institution shall, because of an individual's race, color, religion, sex, or national origin: (1) Fail or refuse to hire such individual; (2) Discharge such individual; (3) Otherwise discriminate against such individual with respect to such individual's compensation, promotion, or the terms, conditions, or privileges of such individual's employment; or (4) Discriminate in admission to, or employment in, any program of apprenticeship, training, or retraining, including on-the-job training. (b) No member institution shall limit, segregate, or classify its employees in any way which would deprive or tend to deprive any individual of employment opportunities or otherwise adversely affect such individual's status as an employee because of such individual's race, color, religion, sex, or national origin. (c) No member institution shall discriminate against any employee or applicant for employment because such employee or applicant has opposed any employment practice made unlawful by Federal, State, or local law or regulation or because he has in good faith made a charge of such practice or testified, assisted, or participated in any manner in an investigation, proceeding, or hearing of such practice by any lawfully constituted authority. (d) No member institution shall print or publish or cause to be printed or published any notice or advertisement relating to employment by such member institution indicating any preference, limitation, specification, or discrimination based on race, color, religion, sex, or national origin. (e) This regulation shall not apply in any case in which the Federal Equal Employment Opportunities law is made inapplicable by the provisions of section 2000e-1 or sections 2000e-2 (e) through (j) of title 42, United States Code. (f) Any violation of the Department of the Treasury regulations, 41 CFR, Subpart 10-12.8-Equal Opportunity in Employment, as amended from time to time, by a member institution subject to such regulations shall be deemed to be a violation of this Part 528. § 528.8 Complaints. Complaints regarding discrimination in lending by a member institution (e), any person to whom it has delegated its authority in the matter concerned. (c) "Facility" includes all or any part of structures, equipment, or other real or personal property or interests therein, and the provision of facilities includes the construction, expansion, renovation remodeling, alteration or acquisition of facilities. (d) "Federal financial assistance" includes: (1) Grants and loans of Federal funds; (2) The grant or donation of Federal property and interests in property; (3) The detail of Federal personnel; (4) The sale and lease of, and the permission to use (on other than a casual or transient basis), Federal property or any interest in such property without consideration or at a nominal consideration, or at a consideration which is reduced for the purpose of assisting the recipient, or in recognition of the public interest to be served by such sale or lease to the recipient; and (5) Any Federal agreement, arrangement, or other contract which has as one of its purposes the provision of assistance. (e) "Primary recipient" means any recipient that is authorized or required to extend Federal financial assistance to another recipient for the purpose of carrying out a program. (f) "Program" includes any program, project, or activity for the provision of services, financial aid, or other benefits to individuals (including education or training, health, welfare, rehabilitation, housing, or other services, whether provided through employees of the recipient of Federal financial assistance or provided by others through contracts or other arrangements with the recipient, and including work opportunities), or for the provision of facilities for furnishing services, financial aid or other benefits to individuals. The services, financial aid, or other benefits provided under a program receiving Federal financial assistance shall be deemed to include any services, financial aid, or other benefits provided with the aid of Federal financial assistance or with the aid of any nonFederal funds, property, or other resources required to be expended or made available for the program to meet matching requirements or other conditions which must be met in order to receive the Federal financial assistance, and to include any services, financial aid, or other benefits provided in or through a facility provided with the aid of Federal financial assistance or such non-Federal resources. (g) "Recipient" may mean any State, territory, possession, the District of Columbia, or Puerto Rico, or any political subdivision thereof, or instrumentality thereof, any public or private agency, institution, or organization, or other entity, or any individual, in any State, territory, possession, the District of Columbia, or Puerto Rico, to whom Federal financial assistance is extended, directly or through another recipient, for any program, including any successor, assignee, or transferee thereof, but such term does not include any ultimate beneficiary under any such program. § 529.3 Application of this part. This part applies to any program for which Federal financial assistance is authorized under a law administered by the Board, including the Federally assisted programs and activities listed in Appendix A to this part. It also applies to money paid, property transferred, or other Federal financial assistance extended under any such program after the effective date of this part pursuant to an application approved before that effective date, and to any such assistance extended under the Housing Opportunity Allowance Program, pursuant to Part 529 of this subchapter, since the inception of such program. This part does not apply to: (a) Any Federal financial assistance by way of insurance or guaranty contracts; (b) Money paid, property transferred, or other assistance extended under any such program before the effective date of this part; (c) Any assistance to any individual who is the ultimate beneficiary under any such program; or (d) Any employment practice, under any such program, of any employer, employment agency, or labor organization, except to the extent described in § 529.4(c). The fact that a program or activity is not listed in Appendix A to this part shall not mean, if Title VI of the Act is otherwise applicable, that such program is not covered. Other programs under statutes now in force or hereafter enacted may be added to Appendix A to this part. § 529.4 Discrimination prohibited. (a) General. No person in the United States shall, on the grounds of race, color, or national origin be excluded from participation in, be denied the benefits of, or be otherwise subjected to discrimination under, any program to which this part applies. (b) Specific discriminatory actions prohibited. (1) A recipient under any program to which this part applies may not, directly or through contractual or other arrangements, on the grounds of race, color, or national origin (1) Deny a person any service, financial aid, or other benefit provided under the program; (ii) Provide any service, financial aid, or other benefit to a person which is different, or is provided in a different manner, from that provided to others under the program; (iii) Subject a person to segregation or separate treatment in any matter related to his receipt of any service, financial aid, or other benefit under the program; (iv) Restrict a person in any way in the enjoyment of any advantage or privilege enjoyed by others receiving any service, financial aid, or other benefit under the program; (v) Treat a person differently from others in determining whether he satisfies any admission, enrollment, quota, eligibility, membership, or other requirement or condition which persons must meet in order to be provided any service, financial aid, or other benefit provided under the program; or (vi) Deny a person an opportunity to participate in the program through the provision of services or otherwise or afford him an opportunity to do so which is different from that afforded others under the program. (2) A recipient, in determining the types of services, financial aid, or other benefits, or facilities which will be provided under any such program, or the class of persons to whom, or the situations in which, such services, financial aid, other benefits, or facilities will be provided under any such program, or the class of persons to be afforded an opportunity to participate in any such program, may not, directly or through contractual or other arrangements, utilize criteria or methods of administration which have the effect of subjecting persons to discrimination because of their race, color, or national origin, or have the effect of defeating or substantially impairing accomplishment of the objectives of the program with respect to individuals of a particular race, color, or national origin. (3) In determining the site or location of facilities, a recipient or applicant may not make selections with the purpose or effect of excluding persons from, denying them the benefits of, or subjecting them to discrimination under any program to which this regulation applies, on the grounds of race, color, or national origin; or with the purpose or effect of defeating or substantially impairing the accomplishment of the objectives of the Act or this part. (4) As used in this section, the services, financial aid, or other benefits provided under a program receiving Federal financial assistance include any service, financial aid, or other benefit provided in or through a facility provided with the aid of Federal financial assistance. (5) The enumeration of specific forms of prohibited descrimination in this paragraph does not limit the generality of the prohibition in paragraph (a) of this section. (6) This part does not prohibit the consideration of race, color, or national origin if the purpose and effect are to remove or overcome the consequences of practices or impediments which have restricted the availability of, or participation in, the program or activity receiving Federal financial assistance, on the grounds of race, color, or national origin. Where previous discriminatory practice or usage tends, on the grounds of race, color, or national origin, to exclude individuals from participation in, to deny them the benefits of, or to subject them to discrimination under any program or activity to which this part applies, the applicant or recipient has an obligation to take reasonable action to remove or overcome the consequences of the prior discriminatory practice or usage, and to accomplish the purposes of the Act. (c) Employment practices. (1) Where a primary objective of a program of Federal financial assistance to which this part applies is to provide employment, a recipient or other party subject to this part shall not, directly or through contractual or other arrangements, subject a person to discrimination on the grounds of race, color, or national origin in its employment practices under such program (including recruitment or recruitment advertising, hiring, firing, upgrading, promotion, demotion, transfer, layoff, termination, rates of pay or other forms of compensation or benefits, selec |