Please
complete this as fully as possible then print the information and fax
to us.
Type
of Property Residence Second/Vacation
Investment
Property
Address
My primary goal is
to
How much do you need to borrow
Estimated
Property Value Original Purchase
Price
Current
Lender Current
balance
Current PaymentCurrent
rateMy
loan is a
Yearly Tax
Yearly Insurance
Included in payment
Second Mortgage Lender
Balance
Second Payment
Rate
| Name |
|
|
| Address |
|
|
| City, State,
Zip |
statezip |
|
| Time at this
address? |
i.e. 2.5 |
|
| Home Phone |
|
|
| E-mail@where.com |
|
|
| How to
contact |
|
|
| Social Security
# |
|
|
|
|
|
|
| Employer |
|
|
| street &
city |
|
|
| Work Phone # |
|
|
| Self Employed? |
Yes
No |
Yes
No |
| Time at this
Job |
(years) i.e. 2.5 |
|
| Gross Mo.
Income |
i.e. 4200 |
|
| Job Title |
|
|
Previous
Employer & Residence
|
|
Complete
this section if you have been at your job or your home less than 2 years |
| Previous
Address |
|
|
| City, State,
Zip |
|
|
| Time at
address |
(years) i.e 2.5 |
|
| Previous
Employer |
|
|
| City,
State |
|
|
| Time at this
Job |
(years) i.e. 2.5 |
|
|
Credit
Information
|
| My
credit history is |
|
| Co
Borrower's credit is |
|
| Foreclosure |
if yes when |
|
| Bankruptcy |
if yes enter date |
|
| Has
your house payment been late in the last 12 months |
|
| |
>30
>60 >90 |
| Collections,
Charge offs, Judgments, Tax liens - last 24 months? |
|
| Total
minimum monthly payments on credit cards and loans: |
|
|
|
|
Your
Comments help
us understand your specific needs.
|
| By
submitting this application, I/We authorize verification of business/
employment status obtaining a credit report.
|
|