Applicant Name
*
First Name
Last Name
Email
*
Phone
*
(###)
###
####
Social Security Number
*
Date of Birth
*
Age
*
Marital Status
*
Check One
List all dependents of applicant and others who will live with you.
*
(Name, age, gender)
Present Address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Housing Status
*
Check One
Number of years you have lived there
*
Is the number of years less than two?
*
Check One
Applicant: I am willing to complete the required sweat-equity hours
*
Check One
Number of Bedrooms
*
Are there other rooms in the house where you are currently living?
*
Check One (i.e., kitchen, bathroom, living room, dining room)
Do you currently rent or own?
*
Check One
Do you own land?
*
Check One
Name of Current Employer
*
Address of Current Employer
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Business Phone
*
(###)
###
####
Type of Business
*
Years on the Job
*
Name of Last Employer
Address of Last Employer
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Last Business Phone
(###)
###
####
Type of Business
Years on the Job
Do you receive other income not listed above?
*
Does anyone else in your household receive monthly income?
*
e.g., children or other adults who live with you
Household members whose income is listed above
*
Include yours and any other household member you listed.
Name, Date of Birth, Income Source, and Monthly Income
Where will you get the money to make the down payment or pay for closing costs (e.g., savings or parents)? If you borrow the money, whom will you borrow it from, and how will you pay it back?
*
Financial Institution Address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Account Number
*
Do you have other accounts at this financial institution?
*
Do you have other accounts at another financial institution?
*
If you have more accounts, please list them below.
Include the name of the financial institution, address, account number, and current balance for each account.
Separate each account with a comma.
Do you pay a car payment?
*
Do you pay a boat payment?
*
Do you pay a furniture payment?
*
Furniture, Appliances, TVs (includes rent-to-own)
Do you pay alimony?
*
Do you pay child support?
*
Do you pay on a credit card?
*
Do you pay on a second credit card?
*
Do you pay on a third credit card?
*
Do you pay medical bills?
*
Do you have other debt not listed above?
*
List all subscriptions and monthly payment.
*
Separate accounts by comma
Write N/A if un-applicable
List all other monthly expenses
*
Separate expenses by comma
Write N/A if un-applicable
Do you have any outstanding judgments because of a court decision against you?
*
Have you been declared bankrupt within the past seven years?
*
Have you had property foreclosed on or deed in lieu of foreclosure in the past seven years?
*
Are you currently involved in a lawsuit?
*
Have you directly or indirectly been obligated on any loan which resulted in foreclosure, transfer of title in lieu of foreclosure, or judgement?
*
Are you currently delinquent or in default on any federal debt or any other loan, mortgage financial obligation or loan guarantee?
*
Are you paying alimony or child support or separate maintenance?
*
Are you a co-signer or endorser on any loan?
*
Are you a U.S. citizen or permanent resident?
*
Do you wish to furnish this information?
*
Race
Applicant may select more than one racial designation
Ethnicity
Sex
Birthdate
Marital Status
