E-Signature Endorsement Record

Record Generated At: 2024-06-16 07:15:44 (UTC)

IP Address: 50.43.63.202

Endorsed Response

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Welcome to the MESO Credit 101 Program!

Completing this form may take approximately 10-15 minutes. You will have the option to
save your information and come back at a later time.

If you own a business, you may want to have some of your business information available,
such as approximate business start date, estimation of gross annual revenues, and number of
employees (if any).

IMPORTANT: Please note the final steps are required for completing the application:

Once the form is completed, you will click the "SUBMIT" button
Review your response and electronically sign then click the "SUBMIT SIGNED
RESPONSE" button
Check your email and click the link to FINALIZE YOUR SIGNATURE

If you have any questions on the process, please contact us at cb@mesopdx.org.

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CREDIT 101 PROGRAM REGISTRATION: Page 1

ABOUT THE CREDIT 101 PROGRAM

MESO's Credit 101 Program is dedicated to helping individuals build their credit
knowledge, scores, and history. After attending a virtual credit education session to
learn about credit and how it affects you, you will receive a small interest-free
installment loan of $100. Your loan term consists of 10 automatic monthly payments
of $10, which will be reported to the credit bureaus.

WHAT ARE SOME OF THE REASONS TO HAVE A GOOD CREDIT

SCORE/HISTORY

Better chance of credit card and loan approval

Qualify for lower interest rates on credit cards and loans
Approved for higher credit limits
Approval for rental houses and apartments
Better car and home insurance rates
Reward benefits on credit products

WHAT ARE THE BENEFITS OF THE CREDIT 101 LOAN

An installment "trade line" is established on your credit report

Payments will be reported for 10-months to the 3 credit agencies: Experian /
Equifax / Transunion
Your FICO score may increase with timely payments (depending on your other
credit activities)

PROGRAM DETAILS

Cost: $10 program fee

Session: attend a one hour virtual credit education session, if not attended
previously
Process:
Your credit report will be "soft pulled' and sent to you with your loan
agreement
Digitally sign a loan agreement with MESO
$100 loan disbursement made to you

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 Automatic debit of the $10 program fee and monthly payments
Follow-up: participants may request an updated copy of their credit report between 2-4
months of program completion
Repeating the Credit 101 program loan program is available and encouraged!
Attending the credit education session is not required for repeating
Credit101 program
Loan amount of up to $200 and a program fee of up to $20

HOW TO APPLY

Complete this application

Virtual sessions are held twice a month on the first Tuesday at 3:00pm and
second Thursday at 9:00am. Please register for the session you would to attend,
below:

Class schedule options

Tuesday, July 2 @ 3:00pm
Knowledge on credit Establish Improve Credit Program Referral by... (fill in
building Credit Score below)
- Yes - Yes - Yes

Other (fill in below)

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CREDIT 101 PROGRAM REGISTRATION: Page 2 of 6

PERSONAL INFORMATION
Legal First Name Legal Last Name
Michael Standley
Residential Street address (including apartment/unit number)
1590 Idaho Ave
City State Zip/postal-code
Coos Bay Oregon 97420
Preferred email Email
Personal standley777@gmail.com
Preferred phone
Mobile
Mobile Phone
(541) 217-3642
Preferred communication method
Text
SMS Ok? (Standard message and data rates from your carrier may apply)
Yes

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CREDIT 101 PROGRAM REGISTRATION: Page 3 of 6

INCOME AND DEMOGRAPHIC INFOMATION
Because MESO receives public funds to cover part of our costs, we are required to
collect income and demographic information on our participants. Demographic
information is not used by MESO in deciding to grant or deny loans. We
appreciate your willingness to assist us by completing the following:
Annual household income (adjusted gross income from taxes)
75000
Date of birth (mm/dd/yyyy format) Are you a U.S. Citizen?
09/07/1982 Yes
Gender LGBTQIA+
Male No
Pronouns
He/Him
Disability? Homeless or formerly homeless
No Yes
Housing
Rent
Veteran? Limited English Proficiency
No Prefer not to answer
Race
White
Ethnicity
Non-Hispanic

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CREDIT 101 PROGRAM REGISTRATION: Page 4 of 6

Do you own a business
Yes
BUSINESS OWNER
Name of business Business start date (mm/dd/yyy format)
Residential Construction llc 05/01/2023
Business address
64109 Solari rd
Business city Business state Business zipcode
COOS Bay Oregon 97420
Business phone Business Phone Type
(541) 238-8501 Cell
Business email Business website
residentialconstruction541@gmail.com
Nature of business
General Contractor
EIN
93-1653362
Gross annual revenue
350000.00
# of employees including owner(s)
1
How Long in Business? Business Type
6 months - 1 year LLC
Do you have business Do you have a business business checking
insurance? account?
Yes Yes

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CREDIT 101 PROGRAM REGISTRATION: Page 5 of 6

Do you have co-owners?
No

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CREDIT 101 PROGRAM REGISTRATION: Last page

before signing!
Use of funds. Describe how you will use these funds (eg: working capital, equipment,
furniture...)
Working capital, equiptment finance
Applicant's Tax Identifier Type
Social Security Number (SSN)
Applicant's Social Security Number (SSN) or Individual Taxpayer Identification
Number (ITIN)
543-04-6598

On the next page you will be able to review your submission and
electronically sign your application.

After completing the signature you will receive an email with a link
to verify your signature. Please check your junk/spam folder for
that email and be sure you click the link in the email to verify your
application signature.

VERIFY YOUR INFORMATION IS CORRECT BEFORE PROCEDING. If

your information is incorrect use the "Previous" button below to go back to the
2nd page of the application and update your email. Your answers will not be lost.
First Name Last Name
Michael Standley
Street Address (with apartment/unit)
1590 Idaho Ave
City State Zip Code
Coos Bay Oregon 97420
Date of Birth Email
09/07/1982 standley777@gmail.com
DISCLOSURES

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 Notice: Right to copy and release of credit report. Upon denial of loan request you may
request in writing a copy of your consumer credit report. All associated fees
regarding the consumer credit report must be made to MESO before the credit report is
released to consumer.

Notice: Right to copy of appraisal. We may order an appraisal to determine the property’s
value and charge you for this appraisal. We will promptly give you a copy of any appraisal,
even if your loan does not close. You can pay for an additional appraisal for your own use at
your own cost.

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 applicant's 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 FDIC
Consumer Response Center, 1100 Walnut St, Box #11, Kansas City, MO 64106.

Notice: If your application for business credit is denied, you have the right to a written
statement of the specific reasons for the denial. To obtain the statement, please contact Micro
Enterprise Services of Oregon (MESO), Attn: Loan Department, 4008 NE Martin Luther
King, Blvd. Portland, Oregon 97212, Office: 503-841-3351 within sixty (60) days from the
date you are notified of our decision. We will send you a written statement of reasons for the
denial within thirty (30) days of receiving your request for the statement.

WASHINGTON TRANSACTIONS: ORAL AGREEMENTS OR ORAL COMMITMENTS

TO LEND MONEY EXTEND CREDIT OR FORBEAR FROM ENFORCING
REPAYMENT OF A DEBT IS NOT ENFORCEABLE UNDER WASHINGTON STATE
LAW.

OREGON TRANSACTIONS: UNDER OREGON LAW, MOST AGREEMENTS,

PROMISES AND COMMITMENTS MADE BY US CONCERNING LOANS AND OTHER
CREDIT EXTENSIONS THAT ARE NOT FOR PERSONAL, FAMILY OR HOUSEHOLD
PURPOSES OR SECURED SOLELY BY THE BORROWER’S RESIDENCE MUST BE IN
WRITING, EXPRESS CONSIDERATION AND BE SIGNED BY US TO BE
ENFORCEABLE.

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 Your Signature

I hereby Authorize Micro Enterprise Services of Oregon to obtain and review my credit
report. My credit report will be obtained from a credit reporting agency or agencies
chosen by MESO. I understand and agree that MESO intends to use the credit report for
the purpose of evaluating my financial readiness to get a business loan.

SIGNATURE

Michael Standley
NAME

2024-06-16 07:13:52
DATETIME (UTC)

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 https://app.formassembly.com/esignatures/export/16e07b65-9 be715e7f9e91a0751acd476e2472aa8b5b0c4c54accd76ef51170 6/16/24, 12 15 AM
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 Response Endorsement Record

Response Submission

Form CREDIT 101 PROGRAM

Form ID 4998969

Form Version 245

Response ID 342548280

Submission Datetime 2024-06-16 07:10:16

Events

2024-06-16 07:10:16 Initialized. E-Signature record created.

2024-06-16 07:10:16 Started. Endorsement process started.

2024-06-16 07:13:52
Endorsed. E-Signature record endorsed by signatory. The response was locked.

2024-06-16 07:14:43 Completed. E-Signature record completed.

2024-06-16 07:14:43
Locked. E-Signature record sealed, notified signatory and form creator.

2024-06-16 07:14:43 Sealed.

Signatory

Name Michael Standley(Respondent)

Email Address standley777@gmail.com

IP Address 50.43.63.202

Signatory UUID 8c4e0528-acc3-4abe-9fcf-f87ed2329352

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 Record

Record UUID 16e07b65-91ef-4ccc-9872-2b8a596604e1

Sealed Record Checksum

e83fc127dbb00ac253087efe4bb0dab7ba8d57a0b8b20ce3350d8f79faccceb9

Sealed Record Signature Hash

311fcbaa17cb0decce4a925ae842c9d3cf9a101d831a265b69cf3f0ee8018e87

Custodian Signature Hash

90dd45473aee49626fb54948a5d7d25e27827c041018426604a4144d2a421137

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