Borrower Personal Information (required)

FIRST NAME

LAST NAME

MARITAL STATUS

SOCIAL SECURITY NUMBER

YRS AT CURRENT ADDRESS

HOME STATUS

CURRENT HOME ADDRESS

CURRENT HOME CITY

CURRENT HOME STATE

CURRENT HOME ZIP

HOME PHONE

WORK OR CELL PHONE

EMAIL ADDRESS

Co-Borrower Personal Information (optional)

FIRST NAME

LAST NAME

MARITAL STATUS

SOCIAL SECURITY NUMBER

YRS AT CURRENT ADDRESS

HOME STATUS

CURRENT HOME ADDRESS

CURRENT HOME CITY

CURRENT HOME STATE

CURRENT HOME ZIP

HOME PHONE

WORK OR CELL PHONE

EMAIL ADDRESS

Borrower Financial Information (required)

AMOUNT IN CHECKING

AMOUNT IN SAVINGS

AMOUNT IN STOCKS/BONDS

MORTGAGE PAYMENT (monthly)

HOUSEHOLD EXPENSE (monthly)

REVOLVING DEBT (monthly)

CURRENT CREDIT STANDING

Co-Borrower Financial Information (optional)

AMOUNT IN CHECKING

AMOUNT IN SAVINGS

AMOUNT IN STOCKS/BONDS

MORTGAGE PAYMENT (monthly)

HOUSEHOLD EXPENSE (monthly)

REVOLVING DEBT (monthly)

CURRENT CREDIT STANDING

Subject Property Information (required)

PROPERTY ADDRESS

PROPERTY CITY

PROPERTY STATE

PROPERTY ZIP

PROPERTY TYPE

PROPERTY USE

PROPERTY TAXES (annual)

ASSOC. FEES (annual)

EXISTING MORTGAGE(S)

REQUESTED LOAN AMOUNT

PROPERTY PURCHASE PRICE

Employment Information (required)

IS BORROWER SELF-EMPLOYED?

BORROWER GROSS MO. INCOME

IS CO-BORROWER SELF-EMPLOYED?

CO-BORROWER GROSS MO. INCOME

Borrower's Previous Address (required)

PREVIOUS HOME ADDRESS

PREVIOUS HOME CITY

PREVIOUS HOME STATE

PREVIOUS HOME ZIP

Borrower Disclosures (required)

ANY BANKRUPTCIES IN THE PAST 7 YRS?

ANY FORECLOSURES IN THE PAST 7 YRS?

ANY FEDERAL LIENS / DELINQUENCIES?

Co-Borrower Disclosures (optional)

ANY BANKRUPTCIES IN THE PAST 7 YRS?

ANY FORECLOSURES IN THE PAST 7 YRS?

ANY FEDERAL LIENS / DELINQUENCIES?