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PERSONAL INFORMATION
Social Security Number (Borrower)
Social Security Number (Co-Borrower)
Name (Borrower)
Name (Co-Borrower)
Current Address	Street: City: State:    Zip:
Telephone Number
Best time to contact you
Email Address
Yearly Income
Number of Years with Current Employer
CREDIT HISTORY	Excellent Good Fair Poor Don’t Know
Monthly Debt
Car Loan
Credit Cards
Other Loans
PROPERTY INFORMATION
Purpose of Loan	PURCHASE= Property Identified PURCHASE=Still Looking REFINANCE INVESTOR LOAN HOME EQUITY LOAN
Property Value
Loan Amount you are applying for
Property Type	Single Family Condo or Townhouse Duplex or Triplex or Fourplex Commercial Planned Unit Development Other
Property will be	Primary Residence Secondary Residence Investment Property
How did you find out about us?	Internet Mail Friend Other
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