Purpose of the Loan:

Property will be:

Number of Units:

Year Built:

Subject Property Address:

Street Address:

City:

State:

Zip:

Property Value:

Loan Amount:

Loan Type:

Interest Rate Expected:

Please complete the information below for the borrower.

Borrower:

First Name:

Middle Initial:

Last Name:

Home Phone:

Business Phone:

Email Address:

Street Address:

City:

State:

Zip:

Rent or Own:

Number of years live at address above:

Years at current job:

Years in current profession:

Are you self-employed?

* Total Monthly Payments on debts:

Please complete the information below for the co-borrower (if any).

Co-borrower:

First Name:

Middle Initial:

Last Name:

Home Phone:

Business Phone:

Email Address:

Street Address:

City:

State:

Zip:

Rent or Own:

Number of years live at address above:

Years at current job:

Years in current profession:

Are you self-employed?

* Total Monthly Payments on debts:

Funds available for Down Payment,
closing costs and reserves (estimated):

Monthly Income Information:

Borrower's Gross Monthly Income

* Base Employee Income:

Overtime:

Bonuses:

Commissions:

Dividends/Interest:

Net Rental Income:

** Other Income:

Co-Borrower's Gross Monthly Income

* Base Employee Income:

Overtime:

Bonuses:

Commissions:

Dividends/Interest:

Net Rental Income:

** Other Income:

** NOTICE: Alimony, Child Support, or separate maintenance income NEED NOT be revealed if the Borrower (B) or Co-borrower (C) does not choose to have it considered for repaying this loan.