| Loan application |
| Borrower Full Name: |
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| Present Street Address: |
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| City: |
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| State: |
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| Zip: |
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| E-Mail: |
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| Home Phone: |
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| DOB: |
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| SSN: |
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| Martial Status: |
Yes No |
| Residence Information: |
| Own/Rent: |
Own Rent |
| Number of years at this residence: |
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| Loan Amount Requested: |
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| Interest Rate Requested: |
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| Number Of Month: |
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| Type of Loan: |
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| Purpose of this loan: |
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| Property will be: |
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| Type of Loan: |
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| If refinance, present mortgage balance: |
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| House Market Value: |
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| If residing less than two years: |
| Former Address (CSZ): |
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| Number of Years at this residence: |
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| Own/Rent: |
Own Rent |
| Employment: |
| Employer Name: |
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| Yrs on this Job: |
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| Yrs Employed/Profession: |
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| Position/Title |
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| Business Phone: |
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| Self Employed: |
Yes No |
| If employed for less than 2 years, or currently employed
in more than 1 position: |
| Employer Name: |
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| Yrs on this Job: |
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| Yrs Employed/Profession: |
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| Position/Title: |
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| Business Phone: |
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| Self Employed: |
Yes No |
| Borrower's Credit |
| How do you rate your credit: |
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| Explain Issues: |
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| Co-Borrower Information: |
| Full Name: |
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| Address: |
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| City: |
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| State: |
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| Zip: |
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| E-Mail: |
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| Home Phone: |
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| DOB: |
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| SSN: |
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| Martial Status: |
Yes
No |
| Co-Borrower If Residing Less Than Two
Years: |
| Former Address (CSZ): |
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| Number of Years at this residence: |
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| Own/Rent: |
Own Rent |
| Co-Borrower Employment: |
| Employer Name: |
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| Yrs on this Job: |
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| Yrs Employed/Profession: |
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| Position/Title: |
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| Business Phone: |
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| Self Employed: |
Yes No |
| If employed for less than 2 years, or currently employed
in more than 1 position: |
| Employer Name: |
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| Yrs on this Job: |
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| Yrs Employed/Profession: |
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| Position/Title: |
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| Business Phone: |
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| Self Employed |
Yes
No |
| Co-Borrower's Credit |
| How do you rate your credit: |
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| Explain Issues: |
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| Gross Monthly
Income: |