BORROWER
CO-BORROWER
Borrower's First Name/Last Name
Co-Borrower's First Name/Last Name
Borrower's E-Mail Address
Co-Borrower's E-Mail Address
Borrower's Area Code/Phone
Borrower's Area Code/Phone
Borrower's Social Security Number
Co-Borrower's Social Security Number
Co-Borrower's Date of Birth
Borrower's Current Address
Co-Borrower's Current Address
How Long at Current Address?
PLEASE SELECT ONE
Under 2 Years
2-3 Years
3-4 Years
4-5 Years
Over 5 Years
How Long at Current Address?
PLEASE SELECT ONE
Under 2 Years
2-3 Years
3-4 Years
4-5 Years
Over 5 Years
PLEASE SELECT ONE
I own this house
I rent this house
I rent this apartment
I live with family
PLEASE SELECT ONE
I own this house
I rent this house
I rent this apartment
I live with family
If Under 2 Years, Previous Address?
If Under 2 Years, Previous Address?
Employer's Name?
Employer's Name?
Employer's Phone?
Employer's Phone?
PLEASE SELECT ONE
Employee (W-2)
Self-Employed (1099)
I'm Not Currently Employed
Disabled and Collect SSI
PLEASE SELECT ONE
Employee (W-2)
Self-Employed (1099)
I'm Not Currently Employed
Disabled and Collect SSI
Borrower's GROSS Monthly Pay (before deductions)
Co-Borrower's GROSS Monthly Pay (before deductions)
PLEASE SELECT ONE
Under 1 Year
1-2 Years
2-3 Years
3-5 Years
Over 5 Years
PLEASE SELECT ONE
Under 1 Year
1-2 Years
2-3 Years
3-5 Years
Over 5 Years
if Under 2 Years, Previous Employer?
if Under 2 Years, Previous Employer?
City/State
City/State
How Would You Rate Your Credit?
PLEASE SELECT ONE
Excellent
Good
Fair
Poor
Terrible
How Would You Rate Your Credit?
PLEASE SELECT ONE
Excellent
Good
Fair
Poor
Terrible
Have You Filed for Bankruptcy within the Past 7 Years?
PLEASE SELECT ONE
Yes
No
Have You Filed for Bankruptcy within the Past 7 Years?
PLEASE SELECT ONE
Yes
No
If YES, What Year was Your Bankruptcy Discharged?
If YES, What Year was Your Bankruptcy Discharged?
Have you had Any Property Foreclosed in the Past 7 Years?
PLEASE SELECT ONE
Yes
No
Have you had Any Property Foreclosed in the Past 7 Years?
PLEASE SELECT ONE
Yes
No
If YES, What Year did the Foreclosure Take Place?
If YES, What Year did the Foreclosure Take Place?
Are you delinquent or in collection on any Child Support payments?
PLEASE SELECT ONE
Yes
No
Are you delinquent or in collection on any Child Support payments?
PLEASE SELECT ONE
Yes
No
Are you delinquent or in collection on any Student Loan payments?
PLEASE SELECT ONE
Yes
No
Are you delinquent or in collection on any Student Loan payments?
PLEASE SELECT ONE
Yes
No
Do you have at least 3% of the purchase price for a down payment?
PLEASE SELECT ONE
Yes, I have at least 3% down
I plan to put MORE than 3% down
Family is helping
I Need a ZERO DOWN loan
Do you have at least 3% of the purchase price for a down payment?
PLEASE SELECT ONE
Yes, I have at least 3% down
I plan to put MORE than 3% down
Family is helping
I Need a ZERO DOWN loan
Are You Currently Working with a Realtor?
PLEASE SELECT ONE
Yes
No
Are You Currently Working with a Realtor?
PLEASE SELECT ONE
Yes
No
PLEASE SELECT ONE
Under Contract
Made Offer
Still Looking
PLEASE SELECT ONE
Under Contract
Made Offer
Still Looking
How are You Related to the Co-Borrower?
PLEASE SELECT ONE
By Marriage
Engaged or Otherwise Involved
Family Member
Friend
I Don't Have a Co-Borrower
How are You Related to the Borrower?
PLEASE SELECT ONE
By Marriage
Engaged or Otherwise Involved
Family Member
Friend
I Don't Have a Co-Borrower
Anything Else You Would Like us to Know?
Anything Else You Would Like us to Know?