Social Security Number Home Phone (incl Area code) DOB Yrs. School Social Security Number Home Phone (incl. Area code) DOB (mm/dd/yyyy) Yrs. School Married Separated Dependents (not listed by Co-Borrower) Married Separated Dependents (not listed by Borrower) Unmarried (include single, divorced, widowed) no. ages Unmarried (include single, divorced, widowed) no. ages Present Address Own Rent __No. Yrs. (street, city, state, ZIP) Present Address Own Rent __No. Yrs. (street, city, state, ZIP) Mailing Address, if different from Present Address Mailing Address, if different from Present Address If residing at present address for less than two years, complete the following: Former Address Own Rent __No. Yrs. (street, city, state, ZIP) Former Address Own Rent __No. Yrs. (street, city, state, ZIP) Borrower IV. EMPLOYMENT INFORMATION Co-Borrower Name & Address of Employer Self Employed Yrs. on this job Name & Address of Employer Self Employed Yrs. on this job Yrs. employed in this line of Yrs. employed in this line of work/profession of Business Business Phone (incl. area code) of Business Business (incl. area code) If employed in current position for less than two years or if currently employed in more than one position, complete the following: Name & Address of Employer Self Employed Dates (from – to) Name & Address of Employer Self Employed Dates (from – to) Monthly Income $ Monthly Income $ Position/Title/Type of Business Business (incl. area code) Position/Title/Type of Business Business Phone (incl. area code) Name & Address of Employer Self Employed Dates (from – to) Name & Address of Employer Self Employed (from – to) Monthly Income $ Monthly Income $ Position/Title/Type of Business Business (incl. area code) Position/Title/Type of Business Business Phone (incl. area code) V. MONTHLY INCOME AND COMBINED HOUSING EXPENSE INFORMATION Gross Monthly Income Borrower Total Combined Monthly Housing Expense Present Proposed Base Empl. Income* $ $ $ Rent $ Overtime First Mortgage (P&I) $ Bonuses Other Financing (P&I) Commissions Hazard Insurance
Acct. no. $ Name and address of Company $ Payment/Months $ Name and address of Bank, S&L, or Credit Union Acct. no. Acct. no. $ Name and address of Company $ Payment/Months $ Stocks & Bonds (Company name/number & description) $ Acct. no. Life insurance net cash value $ Name and address of Company $ Payment/Months $ Face amount: $ Subtotal Liquid Assets $ Acct. no. Real estate owned (enter market value from schedule of real estate owned) $ Alimony/Child Support/Separate Maintenance Payments Owned to: $ $ Vested interest in retirement fund $ Net worth of business(es) owned (attach financial statement) $ Job-Related Expense care, union dues, etc.) $ Automobiles owned (make and year) $ Other Assets (itemize) $ Total Monthly Payments $ Total Assets a. $ Net Worth (a minus b) $ Total Liabilities b. $ VI. ASSETS AND LIABILITIES (cont’d) A VI. ASSETS AND LIABILITIES (cont’d) Schedule of Real Estate Owned (If additional properties are owned, use continuation sheet.) Property Address S if sold, PS if pending sale or R if rental being held for income) Type of Property Present Market Value Amount of Mortgages & Gross Rental Income Mortgage Payments Insurance, Maintenance, & Misc. Net Rental Income $ $ $ $ $ $ Totals $ $ $ $ $ $