Apply On Line Rick AlkirePresident BrokerMVFI MNLS 216206MVFI DRE 01004342 Email address: Amount: $ Purpose of Loan: PurchaseConstruction PermanentConstructionRefinanceReverse MortgageOther 1. BORROWER INFORMATION Borrower Co Borrower Name (include Jr. or Sr. if applicable) Name (include Jr. or Sr. if applicable) Soc. Sec. Nbr. Home Phone Soc. Sec. Nbr. 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: JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecemberYr: To: JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecemberYr: Self-employed Yes No From: JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecemberYr: To: JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecemberYr: 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 JointlyASSETSName & Address of Bank, S&L, or Credit Union: Acct. no. Cash or Market Value: $ LIABILITIES TotalMonthly Payments $