(One Form per Borrower)

PART I (Property Information)

Loan Amount Requested $

Purpose:
(ie purchase or refinance, owner occupied or investment, etc)

Full Address of Property to be financed:

Value $

Property Type: Choose Property Type Owner-occupied Rental 2nd Home

Structure Type: Choose Structure Type standard stick-built home manufactured condo duplex

PART II (Borrower Information)

Name:
Contact Number:
E-mail address:

Rate Your Credit (A-Best, D-Worst):
     A
     B
     C
     D

Present Address:

PART III (Employment)

Current Employer:
Monthly Gross Pay: $
Phone:

Position:
Dates of Employment:
Years in Same Line of Work:

Previous Employer:
(if less than 2 years with current)
Dates of Previous Employment:

PART IV (Liquid Assets):

Checking $
Savings: $
Investments/Retirement $
Life Insurance: $

Other Investments:

PART V (Loans):

Existing Loans (exclude credit cards): Name of Lender, Balance, Payment/Month

Existing Rental Property Information (list each property)

Comments:

How did you hear about us? (ie Realtor's Name & Phone #, or ad)