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 MINI APPLICATION (please fill in information the best you can...)

 BORROWER INFORMATION
 

Borrower

Co-Borrower
Name: 
Soc Sec #:       Years School
Home Phone:      DOB:
Marital Status:

Own or Rent:    No of Years
Name: 
Soc Sec #:       Years School
Home Phone:      DOB:
Marital Status:

Own or Rent:  No of Years
 

 EMPLOYMENT INFORMATION
 

Borrower

Co-Borrower
 

Self Employed:    Years on this Job
Years in this line of work: Bus.Phone:

 

Self Employed:    Years on this Job
Years in this line of work: Bus.Phone:

 

 MONTHLY INCOME AND COMBINED HOUSING EXPENSE INFORMATION
 

Gross Monthly
Income

 Borrower

 Co-Borrower
Base Empl. Income*
Overtime
Bonuses
Commissions
Dividends/Interest
Net Rental Income
Other ** see below
     
TOTAL

Assets &
Liabilities

Borrower

Co-Borrower
Checking Balance
Savings Balance
Credit Card Balances
Auto Payments (Month)
Other Monthly Debt
     
     
     
     
 
Email  
 
Borrower Signature     Date:
                                                                
Co-Borrower Signature      Date:
                                                        
  
*Your Information will be used  to determine credit worthiness*
 

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