Please Submit $35.00 for Credit Report Fee. If Not

APPLICATION PLEASE SUBMIT $35.00 FOR CREDIT REPORT FEE. IF NOT APPROVED, YOU BOUGHT A CREDIT REPORT

BORROWER INFORMATION

Name Social Security Number Home Phone Number D.O.B. Age Marital Status # of Dependents Ages

Present Address City State Zip How Long Own Rent

Previous Address City State Zip How Long Own Rent

EMPLOYMENT INFORMATION

Name & Address of Employer/ Company if Self- Employed Street City State Zip Phone Number

Yrs. on Job Type of Business Title/Position

If employed in current position less than 2 years or employed in more than one position, complete below for past employment (you may use back of application if needed):

Name & Address of Employer/ Company if Self- Employed Street City State Zip Phone Number

Yrs. on Job Type of Business Title/Position

MONTHLY INCOME/ASSET/EXPENSE INFORMATION

Gross Monthly Income Other Monthly Income (Please Describe Below, child support/alimony etc)

Total Monthly Expenses that will show on credit report with a balance of longer than 9 months? Amount of current rent or mortgage Number of people in household Amount of Proposed Mortgage (monthly) Taxes and Insurance $ How much do you have available for down payment? What type of home are you looking for? Where? Balance of checking/savings Stocks or Bonds Life Insurance (cash value) Real estate owned Retirement account Net worth of business owned Auto #1 (make/ year/value) Auto #2 (make/ year/value) Auto #3 (make/ year/value) Auto #4 (make/ year/value) Other Assets DECLARATIONS If you answer YES to any of the questions below, please explain below or attach a continuation sheet with explanation. 1. Are there any outstanding judgments against you? 2. Have you been declared bankrupt within the past 7 years? 3. Have you had property foreclosed upon you in the last 7 years? 4. Are you a party to a lawsuit? 5. Are you obligated to pay alimony or child support? 6. Is any part of the down payment borrowed? 7. Will this be a non-owner occupied residence? 8. Are you a US Citizen?

ACKNOWLEDGMENT AND AGREEMENT

I certify that the above information is correct as of the date set forth above, I understand that any intentional or negligent misrepresentation(s) of the information above may result in civil liability and /or criminal penalties. Verification or re-verification of any information contained in the application may be made at any time by the lender, its agents, successors and assigns, either directly or through a credit-reporting agency, and from any source named in this application.

Borrower’s Signature Date Co-Borrower’s Signature Date

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