LOAN APPLICATION

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Section A: Primary Applicant
1
Personal Information
Email Address*
 
First Name* MI Last Name*
   
Social Security Number* Number of Dependents (including self)*
   
Date of Birth* Home Phone* Other Phone
   
2
Residence
Residence Monthly Rent/Mortgage Payment*
 
Landlord/Mortgage Holder*
 
Current Street Address*
 
City* State* Zip*
     
Years at Current Address*
 
Previous Address if less than 2 years at current address.
Previous Street Address
City State Zip
Years at Previous Address
3
Employment
Current Employer* Employer's Phone*
   
Employer's Street Address*
 
City* State* Zip*
     
Time on Current Job
Your Job Title* Gross Annual Wage*
   
Previous Employer (or school) if less than 2 years at current employer.
Previous Employer Employer's Phone
Employer's Street Address
City State Zip
Time on Previous Job
4
Additional Income
Description Annual Amount
5
Budget
Maximum Down Payment*
 
Maximum Monthly Affordable Payment*
 
6
Miscellaneous
Bank Accounts Have Home Phone*
Savings Checking
No Yes
Have you had any of the following:
Garnishment Bankruptcy Repossession
Section B: Secondary Applicant (optional)
Complete sections 1 -3 below if you are applying with a joint applicant, such as a spouse, or if you are applying with a co-signer.
Secondary Applicant Type*
None Co-Signer Joint Applicant
1
Personal Information
Email Address
First Name MI Last Name
Social Security Number Date of Birth
Home Phone Work Phone
2
Residence
Current Street Address
City State Zip
Years at Current Address
3