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Please fill out all sections below

  Type of loan
 Borrower Information
 Borrower's Full Name

 Social Security Number

 Date of birth
 Current home address
 Home Phone
 Cell Phone
 Work Phone
 E-mail
 The best way to reach me is:
 Employer:
 How long at this job:
 Hourly Rate or Salary:

per

Co-Borrower Information
 Co-borrower's Full Name

 Social Security Number

 Date of birth
 Current home address
 Home Phone
 Cell Phone
 Work Phone
 E-mail
 The best way to reach me is:
 Employer:
 How long at this job:
 Hourly Rate or Salary:

per


Please answer the questions below to the best of your knowledge:


 Have you filed and been discharged from a bankruptcy within the last 7 years?

 Do you have unsatisfied judgments against you?  
 Have you had any real estate foreclosed in the past 7 years?  

 Have you had an auto that was repossessed or voluntarily surrendered?

 Do you have any student loans or IRS liens that are in default? 
 Are you currently behind in court ordered child support payments? 
 Do you receive earned income or child support payments? 
 Amount of available down payment for purchase?  
 By clicking submit, you authorize Partners Home Lending to obtain a credit report to assist in verifying my/our credit worthiness. I/we acknowledge that the information derived from this form may be given to the real estate broker/agent.

 






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