THIS APPLICATION IS DESIGNED TO BE COMPLETED BY THE APPLICANT. YOU MAY APPLY FOR CREDIT EITHER INDIVIDUALLY OR JOINTLY WITH A CO-APPLICANT.

Applicant and Co-applicant must be over 18 years of age to apply for a loan.


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Loan Type

How are you Applying?





Applicant Information


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Previous Address is mandatory if you are at the current Address for less than 2 years

Years : Months :

Employment Information


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Previous Employer / Company Name information is mandatory if your in the current job for less than 2 years

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From : To :

Other Income

NOTE: Alimony, child support, or separate income does not need to be revealed unless you want it considered for repayment of this obligation

Information for Government Monitoring Purposes

The following information is requested by the Federal Government for certain types of loans related to a dwelling in order to monitor the lender's compliance with equal credit opportunity, fair housing, and home mortgage disclosures laws. You are not required to furnish this information, but are encouraged to do so. The law provides that a lender may discriminate neither on the basis of this information, nor on whether you choose to furnish it. If you furnish the information, please provide both ethnicity and race. For race, you may check more than one designation. If you do not furnish ethnicity, race, or sex, under Federal regulations, this lender is required to note the information on the basis of visual observation or surname. If you do not wish to furnish the information, please check the box below. (Lender must review the above material to assure that the disclosures satisfy all requirements to which the lender is subject under applicable state law for the particular type of loan applied for.)

Co-Applicant Information


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Previous Address is mandatory if you are at the current Address for less than 2 years

Years : Months :

Employment Information


- -

Previous Employer / Company Name information is mandatory if your in the current job for less than 2 years

- -

From : To :

Other Income

NOTE: Alimony, child support, or separate income does not need to be revealed unless you want it considered for repayment of this obligation

Information for Government Monitoring Purposes

The following information is requested by the Federal Government for certain types of loans related to a dwelling in order to monitor the lender's compliance with equal credit opportunity, fair housing, and home mortgage disclosures laws. You are not required to furnish this information, but are encouraged to do so. The law provides that a lender may discriminate neither on the basis of this information, nor on whether you choose to furnish it. If you furnish the information, please provide both ethnicity and race. For race, you may check more than one designation. If you do not furnish ethnicity, race, or sex, under Federal regulations, this lender is required to note the information on the basis of visual observation or surname. If you do not wish to furnish the information, please check the box below. (Lender must review the above material to assure that the disclosures satisfy all requirements to which the lender is subject under applicable state law for the particular type of loan applied for.)

Manufactured Home


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APPLICANT'S SIGNATURE DATE CO-APPLICANT'S SIGNATURE DATE LOAN ORIGINATOR SIGNATURE LOAN ORIG. NO.
APPLICANT      Label                 CO-APPLICANT     Label
SECTION 8:  LAND / HOME COMBINATION