1. GUARANTOR INFORMATION

FIRST NAME
MIDDLE NAME
LAST NAME
SOCIAL SECURITY NUMBER
PRESENT ADDRESS (STREET)
PRESENT ADDRESS (CITY)
PRESENT ADDRESS (STATE)
PRESENT ADDRESS (ZIP)
PRESENT ADDRESS (STATUS)
PRIOR ADDRESS (IF RESIDING AT PRESENT ADDRESS LESS THAN TWO YEARS)
PRIOR ADDRESS (STATUS)
EMAIL ADDRESS
DATE OF BIRTH
BUSINESS PHONE
FAX NUMBER
CELL NUMBER
HOME NUMBER
DRIVER LICENSE NUMBER & STATE

2. EMPLOYMENT INFORMATION

NAME OF EMPLOYER
ADDRESS OF EMPLOYER
PHONE NUMBER
POSITION/TITLE/TYPE OF BUSINESS
TYPE OF BUSINESS
PRIOR EMPLOYER (IF EMPLOYED AT CURRENT POSITION LESS THAN TWO
POSITION/TITLE/TYPE OF BUSINESS
YEARS ON THE JOB
SELF EMPLOYED?

3 (a). MONTHLY INCOME

INCOME
AMOUNT
SALARY
COMMISSIONS
RENTAL INCOME
INTEREST INCOME
INVESTMENT INCOME
ADD OTHER INCOME

3 (b). EXPENSE INFORMATION

EXPENSES
AMOUNT
FEDERAL & STATE TAXES
MORTGAGE PAYMENTS – RES
MORTGAGE PAYMENTS – INV
RENT OR CONDO/COOP FEES
AUTOMOBILE
ADD OTHER EXPENSES

4 (a). ASSET INFORMATION

INCOME
AMOUNT
CASH
SECURITIES
RESIDENTIAL REAL ESTATE
INVESTMENT REAL ESTATE
NET WORTH OF BUSINESS
PERSONAL PROPERTY
ADD OTHER ASSET

4 (b). LIABILITY INFORMATION

EXPENSES
AMOUNT
REDERAL STATE OWED
MORTGAGE – RESIDENTIAL
MORTGAGE – INVESTMENTS
CREDIT CARDS
AUTOMOBILE
ADD OTHER LIABILITY

5. SCHEDULE OF REAL ESTATE CURRENTLY OWNED

PROPERTY ADDRESS
TYPE
MARKET VALUE
MORTGAGE
MORTGAGE P&I
RENTAL INCOME
EXPENSES
ADD NEW RECORD

6. SCHEDULE OF REAL ESTATE SOLD

PROPERTY ADDRESS
TYPE
MARKET VALUE
MORTGAGE
MORTGAGE P&I
RENTAL INCOME
EXPENSES
ADD NEW RECORD

6. ACKNOWLEDGEMENT & AGREEMENT

The information contained in this application is provided to induce you to extend or continue the extension of a loan to the undersigned or to others upon the guarantee of the undersigned. The undersigned acknowledges and understands that the lender is relying on the information provided herein to grant or continue credit or to accept a guarantee thereof. The undersigned represents, warrants and certifies that the information provided herein is true, correct and complete. The undersigned authorizes the release of any and all information concerning bank accounts, employment, credit or mortgage verification, as requested. The undersigned also authorizes lender to make all inquiries deemed necessary to verify the accuracy of the statements herein, including obtaining consumer credit reports and background checks from registered credit reporting agencies and government authorities. In addition, the undersigned authorizes that, if the loan applied for is granted, subsequent credit reports or background checks may be run by the lender for the purposes of monitoring the loan.

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