Borrower Information

Full Name:

Date of Birth: mm/dd/yyyy

Number of Dependants:

Current Address:

At Address for: years

Previous Address:

At Address for: years

Contact Information

Work Phone:

Home Phone:

Cell Phone:

Email:

Please contact me: Work Home Cell

Borrower Employment Information

Base Salary: please use before tax amount

Overtime:

Commissions:

Dividends:

Rental Income:

Other Income:

Employment status: Full time Part time Self

Employer's Name:

Job Title:

Co-Borrower Info.

Name:

Date of Birth: mm/dd/yyyy

Number of Dependants:

Current Address:

At Address for: years

Previous Address:

At Address for: years

Co-Borrower Contact Info.

Work Phone:

Home Phone:

Cell Phone:

Email:

Please contact me: Work Home Cell

Co_Borrower Employment Info.

Base Salary: please use before tax amount

Overtime:

Commissions:

Dividends:

Rental Income:

Other Income:

Employment status: Full time Part time Self

Employer's Name:

Job Title:

General Information

How much is your current rent or house payment?

What is the maximum mortgage payment that you would be comfortable with?

How much money will you have available for downpayment and closing costs?

Will any of this money be from gifts? Yes   No

If you are getting a gift, how much will you be getting?

Will you be selling a house? Yes   No

How much do you think your house is worth?

In what month would you like to move? January February March April May June July August September October November December

Are you self employed? Yes   No

Can we verify the income you have stated on your loan application? Yes   No

Will we be able to verify your rent/housing payment for the last twelve months?
Yes    No

Do you receive or pay child support or alimony? Yes   No

How much child support/alimony do you pay per month?

How much child support/alimony do you receive per month?

How do you rate your credit? Excellent   Fair   Poor

If you have any unique situations that you would like us to know about please include them below.

Assets

Approximate balance in your checking account(s)?

Approximate balance in your saving account(s)?

Approximate vested balance in your retirement or 401k?

Approximate value of any other liquid assets (stocks, bonds, investments)?