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Personal Information
Borrower (First, MI & Last)
*
DOB
*
+
Social Security Number
*
Co-Borrower
*
Yes
No
Co-Borrow (First, MI & Last)
*
Co Borrower DOB
*
+
Co-Borrower Social Security Number
*
Home #
*
Work #
Cell #
Email Address
*
Co-Borrower Email Address
*
Present Address
*
City/State
*
Zip
*
Number of Years
*
Previous Address
*
City/State
*
Zip
*
Number of Years
*
Employment History
Borrower's Current Employer
*
Number of Years
*
Number of Months
*
Gross Income/Monthly
*
Years in Field
*
Borrower's Previous Employer
*
Number of Years
*
Co-Borrower's Current Employer
*
Number of Years
*
Years in Field
*
Gross Income/Monthly
*
Co-Borrower's Previous Employer
*
Any Other Sources of Income
Gross Amount/Monthly
Credit Information & Declarations
Amount of Down Payment
Source of Funds
How Would You Describe Your Credit?
*
Excellent
Good
Average
Poor
Borrower Declarations:
*
yes
no
Are there any outstanding judgments against you?
yes
no
Have you been declared bankrupt in the past 7 years?
yes
no
Have you had property foreclosed upon or given title or deed in lieu thereof in the last 7 years?
yes
no
Are you a party to a lawsuit?
yes
no
Have you been obligated on any loan resulted in foreclosure, transfer of title in lieu of foreclosure or judgment?
yes
no
Are you presently delinquent or in default on any Federal debt or any other loan, mortgage, financial obligation, bond or loan guarantee?
yes
no
Are you obligated to pay alimony, child support, or separate maintenance?
yes
no
Is any part of the down payment borrowed?
yes
no
Are you a co-maker or endorser on a note?
yes
no
Are you a U.S. citizen?
yes
no
Are you a permanent resident alien?
yes
no
Do you intend to occupy the property as your primary residence?
yes
no
Have you had ownership interest in a property in the last 3 years?
yes
no
Co-Borrower Declarations:
*
yes
no
Are there any outstanding judgments against you?
yes
no
Have you been declared bankrupt in the past 7 years?
yes
no
Have you had property foreclosed upon or given title or deed in lieu thereof in the last 7 years?
yes
no
Are you a party to a lawsuit?
yes
no
Have you been obligated on any loan resulted in foreclosure, transfer of title in lieu of foreclosure or judgment?
yes
no
Are you presently delinquent or in default on any Federal debt or any other loan, mortgage, financial obligation, bond or loan guarantee?
yes
no
Are you obligated to pay alimony, child support, or separate maintenance?
yes
no
Is any part of the down payment borrowed?
yes
no
Are you a co-maker or endorser on a note?
yes
no
Are you a U.S. citizen?
yes
no
Are you a permanent resident alien?
yes
no
Do you intend to occupy the property as your primary residence?
yes
no
Have you had ownership interest in a property in the last 3 years?
yes
no
If you have had a previous Bankruptcy, Date of Discharge
+
Do You Pay Child Support or Alimony?
*
No
Yes
If Yes, Amount/Mo.
*
Is it Okay to Pull an In-File Credit Report?
*
Yes
No
Who referred you to me?
*
Borrower's Digital Signature
*
Date
*
Co-Borrower's Digital Signature
Date
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This is not a loan application. This is simply a customer detail to order a credit report.
A formal loan application will be taken based on additional Income, Asset and Credit information provided by the customer.
Rates and product availability are subject to change. American Eagle Mortgage Company NMLS #1938. 3009 Columbus St., Grove City, OH 43123