Borrower Co-Borrower
Full Name:
Address:
City, State ZIP:
SSN (no dashes):
Drivers License:
Day Phone (w/area code):
Evening Phone (w/area code):
Email Address:
Date of Birth:

Income - All Amounts are Monthly

  Borrower Co-Borrower Totals
Base Salary:
Overtime:
Bonuses:
Commissions:
Self-Employment:
Net Rental Income:
Other Income A:
Other Income B:
    Total Monthly Income:

Monthly Debt/Expenses (Use minimum of 8 months)

  Borrower Co-Borrower Totals
Auto Payment A:
Auto Payment B:
Credit Cards:
(total outstanding balances)
Installment Payments Debt:
Net Rental Loss:
(75% gross rents minus
Payments/Taxes/Ins)
Other:
    Total Monthly Expenses:

Down Payment Available (60 days average liquid balance)

  Borrower Co-Borrower Totals
Bank Accounts:
Stock Accounts:
Gifts:
Other Source:
  Available for Down Payment:
Estimated cash I want to use for my Down Payment:

Additional Comments, Questions or Concerns