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Loan Amount Requested*
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 Applicant  Co-Applicant
First Name*
 First Name*
Last Name*
 Age
 Last Name*
Social Security Number:
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 Property Information
Owner Occupied Residential Construction,  Vacation Home,  Investment Construction (Spec)
Retail Property Commercial/Industrial
Underlying Condo/Coop Co-op Conversion
Hotel/Motel/Resort Energy Producing Property
Senior or Low Income Housing Development
Property Address
 Street 
 State 
City 
 Zip Code 
Names on Deed 
.Yearly Taxes ($) 
  
Land/Property Development - If Currently Owned
Orig. Purchase Date
 Orig. Purchase Price ($)
Present Market Value ($)
1st Mortgage Balance ($)
 2nd Mortgage Balance ($)
1st Mortgage Holder
 Interest Rate
(%)		 2nd Mortgage Holder
 Interest Rate
(%)

Current Payment ($)
 		Years 
Remaining: 
Current Payment ($)
 Years 
Remaining: 
Include Taxes and insurance ?
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Yes No
Land Aquisition - For New Land Purchase Loans
Have you found the  particular property you want to purchase ?
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Purchase Price:
($)		 Down payment:
($)
Are you in Contract?: Yes No Estimated Closing Date:
Source of Funds: Seller Concession:
(%)
 Applicant Employer  Co- Applicant Employer
Name:
 Name:
Phone:
 Phone
Income Annual ($):
 Income Annual ($):
Self Employed ?
   Self Employed ?
Position:
 Years:
  		 Position:
 Years:
  
Additional Income ($):
 Additional Income ($):
 Other
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