First & Last Name of Borrower:       
Age:   Current Address:       
City, State, Zip:                    
Soc Sec Number:                           
Area Code Telephone#                       
E-mail address, if applicable:       
Previous address if under 2-yrs.:     
City, State, Zip:                    
Type word 'AUTHORIZE' to give authorization for a Credit Report: 
Optional Name of Co-Applicant/Spouse:
Age:   - (You may type the word 'Same' if applicable in fields
below.) -     Current                 
City, State, Zip:                     
Social Security Number:                   
Telephone Number and Area Code:         
E-mail address, if applicable:        
Previous Address if under 2-yrs.:       
City, State, Zip:
Type the word
'AUTHORIZE' in Capital Letters to Authorize Credit Report Inquiry: 
Optional 
City & State Where Buying a house:    
City & State Where Selling a house:   
Property Value: 
Loan Amount:    
DownPayment:          
   
   

   
   EMPLOYMENT BORROWER:
   
Present Employer:                   
Address:                            
City, St., Zip:                    
Years & Months Employed:           -
Current Gross Monthly Income:      
   
Previous Employer if under 2 yrs:  
City, St., Zip:                    
Years & Months Employed:           -
   
   
   

   
   EMPLOYMENT of CO-BORROWER:
   
Present Employer:                   
Address:                              
City, St., Zip:                     
Years & Months Employed:            -
Current Gross Monthly Income:       
   
Previous Employer if under 2 yrs:   
City, St., Zip:                     
Years & Months Employed:            -
   
   
   
   
   
ADDITIONAL INCOME: 
   
 Source:                            
 Gross Monthly Income:              
   
   

   
   CASH ASSETS:  Bank Accounts:  
 Name of Bank:     
 Address:            
 City, St., Zip:   
 Account #:          Balance: $:
 Account #:          Balance: $:
 Name of Bank:       
  
 Address:            
 City, St., Zip:   
 Account #:          Balance: $:
 Account #:          Balance: $:
   
   
   
LIABILITIES:  
 Account Name:    
 Account #:        Loan Balance:   
 Min. Pmt:       
 Account Name:   
 Account #:        Loan Balance:   
 Min. Pymt:      
 Account Name:   
 Account #:        Loan Balance:   
 Min. Pymt:      
 Account Name:   
 Account #:        Loan Balance:   
 Min. Pymt:      
 Account Name:   
 Account #:        Loan Balance:   
 Min. Pymt:      
   TOTAL OF MINIMUM PAYMENTS:  
   
   
EXISTING MORTGAGE/RENT INFORMATION (Last 2-Years)  
 Lender:         
 Address:          
 City, St. Zip:  
 Loan Number:      Balance: $: 
 Monthly Payment:  Sales Price:
 Type of Loan:  FHA, VA, Conv.: 
   
   
RENTAL LANDLORD INFORMATION: (2 Years)  
 Landlord:       
 Address:          
 City, St., Zip: 
 Telephone #