Personal Information:
Borrower Full Name:
Co-Borrower Full Name
Borrower SSN:
Co-Borrower SSN
Borrower Address:
Co-Borrower Address:
DOB
City, State Zip
Contact Infomation:
Borrower Work Phone
Co-Borrower Work Phone
Home Phone
Cell/Mobile Phone
Borrower E-Mail
Co-Borrower E-Mail
Employment Information
Borrower Employment Infomation
Co-Borrower Emplyment Information
Employer Name
Base Annual Salary:
Commisions:
Bouns:
Other Income to Consider:
Other Income to Consider
How long employed with current employer.
How long employed with current employer
Self Employed
NO Yes
How Long Self Employed
Adjusted Gross Income Last Three years:Example: (2000 - $10,000) (2001 - $10,000)(2003 - $10,000)
Loan Information
Amount Seeking
Residential or Commercial Loan
Commercial Residential
Purpose of Loan
Re-Finance 1st Time Purchase 2nd Mortgage Investment Primary Home Vacation Home
Type of Loan
15 Year 20 Year 30 Year ARM
Liabilities
Current Mortgage
Other Mortgages Total
Total Auto Loans
Total Credit Card Debt
Other Dept Totals
Permission:I herby give permission to APLUS MORTGAGE LOANS to seek a credit history check based on the information provided above.APLUS MORTAGE LOANS does not sell or participate in any marketing or information gathering functions and all information is strictly confindencal. No information will be sold or redistriubted by APLUS MORTGAGE LOANS for any other purpose other than required to help applicant qualify for loan.
I give permision to seek credit information
Yes NO
Comments:Any additional comments or information that would be helpful in determining your loan qualification status.