Loan Approval Request

(All items are required to receive a reply)

Borrower Information:

Name:   

Address:  : 

City:    State:  Zip: 

Home Phone:    Work Phone: 

Contact Time: 

Email: 

Borrower Self Employed? Selec One Yes No

Length of Employment: 

Gross Monthly Income:  $

Borrower Credit History:  Select One Excellent Good Fair Poor Some Late Don't Know

Co-Borrower Information:

Name: 

Address: 

City:    State:    Zip: 

Home Phone:    Work Phone: 

Contact Time: 

Email: 

Co-Borrower Self Employed?  Select One Yes No

Length of Employment: 

Gross Monthly Income:  $

Co-Borrower Credit History:  Select One Excellent Good Fair Poor Some Late Don't Know

Loan Information:

Cash Down:  $

Time Frame:  Select One 1 - 3 Months 3 - 6 Months 6 - 9 Months 9 - 12 Months Within 18 Months Within 24 Months Not Sure

Realtor Information:  Select One Not currently working with a realtor Currently working with a realtor. Looking for a realtor. Have a realtor contact me.

Car Payments:  First Car:  $

                        Second Car:  $

Credit Card Debts:  $ (just total)

Other Monthly Debts:  $(just total)