Name

Date of Birth

SSN

Phone

Email:

Years in School

Monthly Income

Your Position at Work

Employer (Name and Address)

Business Phone

Start Date

2 years Employment History

Expected Credit Score

Immigration Status
CitizenGreen CardH1BEADOther

Number of Dependents

Spouse Name

Husband and WifeSingle ManSingle Woman

Loan Details:

Loan Amount

PurchaseRefinance

Loan Term
30 years15 years7/1 ARM5/1 ARMOther

Subject property address

Current Address (Please leave blank for refinance)

Number of years in Current Address

OwnRent

Current Rate of Interest (only for refinance)

Purchase Price

Year built and Year You Acquired

2 years Residential History

List of All Real Estate that you own

Assets (Give Liquid Account Balance for any one account)

List Monthly liabilities (Car payments, Other loans )