Introduction |  Borrower |  Employment |  Assets |  Declarations
Before you begin, make sure you have the following information on hand:
  
  Income information (including bonuses, overtime, and income from any other source) for all borrowers.
  Bank and brokerage account information for all borrowers.
  Social Security number(s) for each borrower.
 
   

First Name:  
Last Name:  
Home Phone:
(incl. area code)		  
Email address:   
Purpose for Loan: Purchase  
Refinance

Estimated purchase price:

 $

Estimated down payment:

 $
BorrowerCo-Borrower
Personal Information:
First Name:
Initial:
Last Name:
(include Jr. or Sr. if applicable)
Social Security Number:
Home Phone:
(incl. area code)
Date Of Birth
(mm/dd/yyyy):
Years In School:  
Marital Status: Married  
Separated  
Unmarried 		Married  
Separated  
Unmarried
 
Present Address:
Street: 
City: 
State:
Zip: 
Residency Status:   Own 
 Rent 		 Own 
 Rent 
Number of Years:
 

If residing at present address for less than two years, enter previous address:
Street:
City
State
Zip:
Own:
Rent:
Number of years:
BorrowerCo-Borrower
Employer Information:
Name of Employer: 
Street Address: 
City: 
State: 
Zip: 
Work Phone: 
Position/Title/
Type of business
Self Employed: 
Years on Job: 
Years in profession: 
Base Employment Income: $$


If employed in current position for less than two years or if currently employed in more than one position, complete the following:
Name of Employer: 
Street Address: 
City: 
State: 
Zip: 
Work Phone: 
Position/Title
/Type of business: 
Title: 
Type of Business: 
Self Employed: 
Employment Dates:   from
 to		  from
 to
Monthly Income:  $ $
BorrowerCo-Borrower
Gross Monthly Income

 
 
 
Assets:

Enter your asset information below
Name of Bank,
Savings & Loan,
or Credit Union: 		 Cash or Market Value:   $
Name of Bank,
Savings & Loan,
or Credit Union: 		 Cash or Market Value:   $
Name of Bank,
Savings & Loan,
or Credit Union: 		 Cash or Market Value:   $
Vested interest in retirement fund: $
Other assets: $

 
Liabilities:
Schedule of Real Estate Owned

Property #1:
Street:  City, State, ZIP: 
Status: 
Gross Rental Income: $ Present Market Value: $

Property #2:
Street:  City, State, ZIP: 
Status: 
Gross Rental Income:  $ Present Market Value:  $

Property #3:
Street:  City, State, ZIP: 
Status: 
Gross Rental Income:  $ Present Market Value:  $
BorrowerCo-Borrower
Declarations:
Are there any outstanding judgments against you?  Yes
 No		  Yes
 No
Have you been bankrupt within the last 7 years?   Yes
 No		  Yes
 No
Have you had property foreclosed upon or given title or deed in lieu thereof in the last 7 years?   Yes
 No		  Yes
 No