Mortgage Application

MORTGAGE APPLICATION
Applicant:__________________________________________ Home Phone: ________________________________
SSN: ____________________________________________ Cell Phone: __________________________________
Email Address: ____________________________________
Co-Applicant:______________________________________ Home Phone: _________________________________
SSN: ____________________________________________ Cell Phone: ___________________________________
Email Address: ____________________________________
Present Street Address: How long at this address? _______________________
________________________________________________ _____________________________________________
(Street Address City and State)
Previous Street Address: How long at this address? _______________________
________________________________________________ _____________________________________________
(Street Address City and State)
No. of Dependents: ______________ Names: __________________________________________________________
Current Employer: _________________________________ How long at company? __________________________
Street Address, City: ______________________________ Phone Number: _______________________________
Position or Title: ___________________________________ Salary or Wages: ______________________________
Previous Employer: _________________________________ How long at company? __________________________
Street Address, City: _______________________________ Phone Number: _______________________________
Name & Address of 2 closet relatives who do not live with you:
Name: ____________________________________________ Phone Number: _______________________________
Address, City, St: __________________________________________________________________________________
Name: ____________________________________________ Phone Number: _______________________________
Address, City, St: __________________________________________________________________________________
Auto: ___________________________________________________________________________________________
(Make Model Year Tag)
Auto: ___________________________________________________________________________________________
(Make Model Year Tag)
Bank Account Info: _________________________________________________________________________________
Bank Name Account #      Checking or Savings
Have you Filed Bankruptcy? ______ Been Sued for Non-Payment of a Debt? ______ Been Evicted? ______

__________________________________________           _______________________________________
Applicant Signature                                                                Co-Applicant Signature