Dennis Harrah
L.A. Rams All Pro
Professional Realtor
Century 21 Real Estate

Application for Mortgage


Mark "The Horse Guy" Winslow
Professional Realtor
Century 21 Real Estate
 

L.A. Rams All-Pro, Dennis Harrah &
Mark Winslow "The Horse Guy"

Team up to provide Professional Mortgage
and Real Estate Services!

  

 
Email address:     
Amount: $           
Purpose of Loan: 
1. BORROWER INFORMATION

Borrower

Co Borrower

  Name (include Jr. or Sr. if applicable)

  Name (include Jr. or Sr. if applicable)

  Social Security Number

 

  Home Phone

 

  Social Security Number

 

 Home Phone

 

Age 

Yrs. of School 

Age 

Yrs. of School 

Birth Date:  e.g. 01/01/1970 Birth Date: e.g.01/01/1973

Marital Status

Married
Unmarried
Separated

Dependents

No.
Ages

Marital Status

Married
Unmarried
Separated

Addl Dependents

No.
Ages

Present Address:

Present Address:

Street

Street

City

City

State 

Zip 

State 

Zip 

Own Rent

No. Yrs.

Own Rent

No. Yrs.

IF AT PRESENT ADDRESS LESS THAN TWO YEARS ...

Former Address:

Former Address:

Street 

Street 

City 

City 

State 

Zip 

State 

Zip 

Own Rent

No. Yrs.

Own Rent

No. Yrs.

2.  EMPLOYMENT INFORMATION

Borrower

Co Borrower

Name of Employer: 

Name of Employer:   

Address:                

Address:                   

City:                       

City:                         

State:

Zip:

State:

Zip:

Self-employed
Yes
No

Years on this job:

Self-employed
Yes
No

Years on this job:

Yrs. in current profession:

Yrs. in current profession:

Position/Title/Type of Bus:

Position/Title/Type of Bus:

Business Phone:                

Business Phone:                

 IF EMPLOYED IN CURRENT POSITION FOR LESS THAN TWO YEARS...

Name of Employer:

Name of Employer:

Attn:      

Attn:       

Address:

Address: 

City:       

City:

State:

Zip:

State:

Zip:

Self-employed
Yes No

From:  Yr: 

To:      Yr: 

Self-employed
Yes No

From:  Yr: 

To:      Yr: 

Monthly Income:$

Monthly Income:$

Position/Title/Type of Bus:

Position/Title/Type of Bus:

Business Phone:

Business Phone:

3. MONTHLY INCOME AND COMBINED HOUSING EXPENSE INFORMATION

Gross Mo. Income

Borrower

Co-Borrower

Base Empl. Income*

$

$

Overtime

$

$

Bonuses

$

$

Commissions

$

$

Dividends/Interest

$

$

Net Rental Income

$

$

Other**

$

$

Total

$

$

* Self Employed Borrower(s) may be required to provide additional documentation such as tax returns and financial statements.

Combined Monthly Housing Expenses

Present

Proposed

Rent

$

$

First Mortgage (P&I)

$

$

Other Financing (P&I)

$

$

Hazard Insurance

$

$

Real Estate Taxes

$

$

Mortgage Insurance

$

$

Homeowner Assoc. Dues

$

$

Other

$

$

Total

$

$

4.  ASSETS AND LIABILITIES

This statement and any applicable supporting schedules may be completed jointly by both married and unmarried Co-borrowers if their assets and liabilities are sufficiently joined so that the Statement can be meaningfully and fairly presented on a combined basis; otherwise separate Statements and Schedules are required. If the Co-Borrower section was completed about a spouse, this Statement and supporting schedules must be completes about that spouse also.

Completed: Jointly Not Jointly

ASSETS

Name & Address of Bank, S&L, or Credit Union:

Acct. no.

Cash or Market Value: $

LIABILITIES

TotalMonthly Payments $