Loan Purpose Sell Home Applicant Name   Co-Applicant Name   Address City State Select AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY Zip Code Mailing Address : Home Phone  (XXX) XXX-XXXX Work Phone  (XXX) XXX-XXXX E-mail Address

Property Type Primary Residence Second Home Town House  Investment Property Commercial Property Mobile Home W/Land Mobile Home WIth Out Land Desired Loan Amount Year Property was Acquired Present Value of Property First Mortgage Lender  Amount Owed on First Mortgage  Current Interest Rate on First Monthly Payment Second Mortgage Lender  Second Mortgage Balance (if any) Current Interest Rate on Second  Second Mortgage Payment Additional Debt Amount Additional Debt Payments

Current Employer/Co.B Employer Years with Current Employer/Co.B Years Monthly Income/Co.B Income How Would You Describe Your Non-Mortgage Credit? Excellent Good Fair Major Credit Issues How Far Behind Are You? 30-60 Days Most of the Time Sometimes 120+ Days Ever had a Bankruptcy? Never Declared Not yet discharged Less than 1 year 1 year 2 years 3 years 4 years 5 years 6 years 7 years Best Time to Call 9AM to 9PM 9AM-11AM 11AM-1PM 1PM-3PM 3PM-5PM 5PM-7PM 7PM-9PM