Applicant & Co-Applicant Information:

Applicant First Name
{{1}}   
Applicant Last Name
{{2}}
Home Phone
{{3}}
Work Phone
{{4}} 		SSN
{{5}}
E-Mail
{{6}}

Co-Applicant First Name
{{7}}   
Co-Applicant Last Name
{{8}}
Home Phone
{{9}}
Work Phone
{{10}}
SSN
{{11}}
E-Mail
{{12}}

Address
{{13}}
City
{{14}}
State
{{15}}
Zip
{{16}}

Gross Income:


1.		 Applicant Employer
{{17}}
Position
{{18}}
{{19}} Years on Job
{{20}} Years in same field

 Monthly Income Amt.
$ {{21}}
Co-Applicant Employer
{{22}}
Position
{{23}}
{{24}} Years on Job
{{25}} Years in same field

 Monthly Income Amt.
$ {{26}}
3. Other Income Applicant
{{27}} 		Monthly Income Amt
$ {{28}}
4. Other Income Co-Applicant
{{29}}
$ {{30}}
Total Gross Monthly Income: $ {{31}}

Assets

1. Cash Deposit (Type of Account)
{{32}} 		Amount
$ {{33}}
2. {{34}} $ {{35}}
1. Checking and Savings Accounts
Financial Institution
{{36}} 		Amount
$ {{37}}
Account Number
{{38}}
2. Financial Institution
{{39}} 		Amount
$ {{40}}
Account Number
41}}
1. Stocks and Bonds (Please Describe)
{{42}} 		Amount
$ {{43}}
2. {{44}} $ {{45}}
3. {{46}} $ {{47}}
1. Life Insurance
{{48}} 		Face Amount
$ {{49}}
1. Automobile Type
 {{50}} 		Est. Value
$ {{51}}
2. {{52}} $ {{53}}
3. {{54}} $ {{55}}
1. Other Assets (Please Describe)
{{56}} 		Amount
$ {{57}}
2. {{58}} $ {{59}}
3. {{60}} $ {{61}}
4. {{62}} $ {{63}}

  Housing Expenses:

Monthly Pymt
1. 1st Mortgage $ {{64}}
2. Property Taxes $ {{65}}
3. Home Owners Insurance $ {{66}}
Total Monthly Housing Expenses: $ {{67}}

   Monthly Debts:

Type of Liability
 Account Number
 Cur. Bal.
 Monthly Pymt
1. {{68}} {{69}} $ {{70}} $ {{71}}
2. {{72}} {{73}} $ {{74}} $ {{75}}
3. {{76}} {{77}} $ {{78}} $ {{79}}
4. {{80}} {{81}} $ {{82}} $ {{83}}
5. {{84}} {{85}} $ {{86}} $ {{87}}
6. {{88}} {{89}} $ {{90}} $ {{91}}
7. {{92}} {{93}} $ {{94}} $ {{95}}

   Type of Loan Requested:

Loan Type:  {{96}}
Residence Type:  {{97}}
Property Type:  {{98}}
Loan Type:  {{99}}
Estimated Loan Amount:  $ {{100}}

 

The best time to contact me 
 would be:  {{101}} {{102}} {{103}}
around:  {{104}} : {{105}} {{106}}
by:  {{107}}
Comments / Questions: 
{{108}}
"I authorize Rentalsillustrated.com Home Finance and/or assigns to obtain my/our credit report for the purpose of determining credit worthiness. The information that is obtained is strictly confidential. By submitting this electronically, this is to be deemed to be the equivalent of the original."  
 
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  {{109}}
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