| * Type of Loan |
|
| * Years of Loan |
|
| Estimated Loan Amount |
|
| Projected Date of Closing |
|
| |
|
| Primary Borrower |
*First Name
Middle Initial
*Last Name
|
*Daytime Phone
*Email
|
*Social Security Number
*Birthdate
|
Current Address
City
|
State
Zip
|
| Co-Borrower |
First Name
Middle Initial
Last Name
|
Daytime Phone
Email
|
Social Security Number
Birthdate
|
Current Address
City
|
State
Zip
|
| Employment Information |
Primary Borrowers Employer
|
Position
Years on Job
Gross Monthly Income
|
Co-Borrowers Employer
|
Position
Years on Job
Gross Monthly Income
|
Other Income
Gross Monthly Income
|
Other Income
Gross Monthly Income
|
Total Gross Monthly Income
|
| Assets |
| Checking & Savings Account |
Financial Institution
Amount
|
Financial Institution
Amount
|
| Retirement Accounts / IRA / 401k / SEP, etc... |
Description
Amount
|
Description
Amount
|
| Stock & Bonds |
Description
Amount
|
Description
Amount
|
| Other Assets |
Description
Amount
|
Description
Amount
|
Description
Amount
|
| Current Housing Expenses |
(Monthly) |
Rent
Lease Expires When
|
1st Mortgage
Approximate Balance
|
2nd Mortgage
Approximate Balance
|
Approximate Home Value
Home is to be
|
| Credit Report Authorization |
| You understand that by clicking on the I AGREE button immediately following this notice, you are providing ‘written instructions’ to National Realty Centers and American Mortgage Centers under the Fair Credit Reporting Act authorizing National Realty Centers and American Mortgage Centers to obtain information from your personal credit profile or other Information from Experian and/or other credit bureaus. You authorize National Realty Centers and American Mortgage Centers to obtain such information solely in accordance with a Mortgage Loan Application. |
| |
Primary Borrower |
Co-Borrower |
| |
| | |
