Red Letter Mortgage -- Purchase Application

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The greatest good you can do for another is not just to share your riches but to reveal to him his own.
~ Benjamin Disraeli

Mortgage Information

Property Information:
No Property
Offer Pending
Under Contract
If under Contract Enter closing Date mm/dd/yyyy

This Home Will Be

Proposed Purchase Price

Down Payment:
Down Payment will come from:
(checking/savings, investment account, sale of stock, sale of home, 401K loan, gift)

Term of Mortgage Requested:
Type (select one): ARM Fixed Undecided

Borrower Information

First Name:	M.I.:	Last Name:
Social Security Number:		Marital Status:
Number of Dependents: Ages:		Birth Date:mm/dd/yyyy Age

Title to be held in the name(s) of:

Co-Borrower Information

First Name:	M.I.:	Last Name:
Social Security Number:		Marital Status:
Number of Dependents: Ages:		Birth Date:mm/dd/yyyy Age

Address Information

Current Address Information

Current Address:

City, State Zip Code:

Years at address: Months at address:

Do you Own, Rent or Live Rent Free:

If Renting, please complete the following:
Landlord's Name: Landlord's Phone:

Previous Address Information (If lived at current address Less Than 2 years)

Previous Address:

City, State Zip Code:

Years at address: Months at address:

Do you Own, Rent or Live Rent Free:

Contact Information

Borrower	Co-Borrower
Daytime Phone:	Daytime Phone:
Home Phone:	Home Phone:
Work Phone:	Work Phone:
Fax:	Fax:
Email:	Email:
Mobile Phone:	Mobile Phone:

Employment Information

Current Employer

Current Employer:

Employer's Address:

City State, Zip Code:

Position or Title:

Time with employer: Years Months

Years in this line of work:

Are you self employed: Yes No
Corporate Relocation: Yes No

Secondary/Previous Employment Information (If Current Employment Less than 2 years)

Previous Employer:

Employer's Address:

City State, Zip Code:

Position or Title:

Time with employer: Years Months

Years in this line of work:

Are you self employed: Yes No
Corporate Relocation: Yes No

Current Co-Borrower Employment Information

Current Employer:

Employer's Address:

City State, Zip Code:

Position or Title:

Time with employer: Years Months

Years in this line of work:

Are you self employed: Yes No
Corporate Relocation: Yes No

Secondary/Previous Co-Borrower Employment Information (If Current Employment Less than 2 years)

Previous Employer:

Employer's Address:

City State, Zip Code:

Position or Title:

Time with employer: Years Months

Years in this line of work:

Are you self employed: Yes No
Corporate Relocation: Yes No

Income Information

Current Borrower Income Information

Monthly Base Income before Taxes: $

Average monthly Overtime before taxes: $

Average monthly Bonuses before Taxes: $

Average monthly Commissions before Taxes: $

Average monthly dividend/interest income before Taxes: $

Other monthly income: $

Description of Other monthly income:

Current Co-Borrower Income Information

Monthly Base Income before Taxes: $

Average monthly Overtime before taxes: $

Average monthly Bonuses before Taxes: $

Average monthly Commissions before Taxes: $

Average monthly dividend/interest income before Taxes: $

Other monthly income: $

Description of Other monthly income:

Borrower Assets

Bank Account(s)

	Bank Name:	Cash or Market Value:
Bank 1
Bank 2
Bank 3
Bank 4
Bank 5

Stocks & Bonds

	Company Name:	Cash or Market Value:
Company 1
Company 2
Company 3
Company 4
Company 5

Other Assets

	Type of Asset	Cash or Market Value:
Vested interest in Retirement Fund:
Net worth of business(es) owned:
Other 1.
Other 2.
Other 3.

Borrower Liabilities

	Company Name:	Unpaid Balance:	Monthly Payment:
Debt 1.
Debt 2.
Debt 3.
Debt 4.
Debt 5.
Debt 6.
Debt 7.
Debt 8.
Debt 9.
Debt 10.

Other Liabilities	Monthly Payment:
Alimony:
Child Support:
Separate Maintenance:
Job Related Expenses:

Acknowledgement

I/we certify that the information provided in this application is true and correct as of the date set forth opposite my/our signature(s) on this application and acknowledge my/our understanding that my intentional or negligent misrepresentation(s) of the information contained in this application may result in civil liability and/or criminal penalties including, but not limited to, fine or imprisonment or both under the provisions of title 18, United States Code, Section 1001, et seq. and liability for monetary damages to the lender, its agents, successors and assigns, insurers and any other person who may suffer any loss due to the reliance upon any misrepresentation which I/we have made on this application.

Borrower Acknowledgement

Co-Borrower Acknowledgement

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