ON LINE CREDIT APPLICATION

NAME   DOB. SOCIAL SECURITY

 Address CITY/STATE/ZIP

 NO. YRS. PHONE OWN  RENT OTHER RENT/MTG. PMT.

E-MAIL   CELL PHONE

FORMER ADDRESS CITY/STATE/ZIP

SINGLEMARRIED UNMARRIEDFINANCIAL DEPENDENTS (INC. SELF)   AGES

CO-PURCHASER  DOB SOCIAL SECURITY

PURCHASER'S EMPLOYER ADDRESS

PHONE TYPE BUSINESS OCCUPATION

MONTHLY INCOME (Gross) YRS. ON JOBOTHER INCOME

CO-PURCHASER'S  EMP ADDRESS

PHONE OCCUPATION   #YRS. workedMO. INCOME (gross)

CHECKING ACCOUNT (with) SAVINGS ACCOUNT (with)

COMMENTS:
(What size, price etc. of home & other information)

THESE QUESTIONS APPLY TO BOTH PURCHASER AND CO-PURCHASER
(If  YES answer is given to a question in this section, explain on an attached sheet)

 Have you had any outstanding judgments ?   In the last 7 years, have you been declared bankrupt ?
Have you had property foreclosed upon or given title or deed in lieu thereof ?Are you a co-maker or endorser on a note ?
Are you a party in a lawsuit? Are you obligated to pay alimony, child support or separate maintenance ?
Is any part of the down payment borrowed ?

GOVERNMENT MONITORING INFORMATION
 The following information is requested by the Federal Government if the loan in related to a dwelling, in order to monitor the lender's compliance with equal credit opportunity and fair housing laws.  You are not required to furnish this information, but are encouraged to do so.  The law provides that a lender may neither discriminate on the basis of this information, nor on whether you choose to furnish it.  However, if you choose not to furnish it, under federal regulations this lender is required to note race and sex on the basis of visual observation or surname.  If you do not wish to furnish the information, please initial. BORROWER: I do not wish to furnish this information.
Race Sex

DATE:   SALES PERSONS NAME (if applicable)  

The undersigned intend or do not intend to occupy the property as their primary residence.

            BORROWER   CO-BORROWER

Please DO NOT submit this application if you aren't interested in purchasing a home .
Fill out as complete as possible, especially those in red.