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Borrower Information
Co-Borrower Information (optional)
Name:
Name:
SSN:
SSN:
Address:
Address:
City, State:
AL
AK
AZ
AR
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MH
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
City, State:
AL
AK
AZ
AR
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MH
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Zip Code:
Zip Code:
Home Phone:
Home Phone:
Work Phone:
Work Phone:
Email Address:
Email Address:
Employment Status:
Full Time
Part Time
Self-Employed
Home Maker
Student
Retired
Employment Status:
Full Time
Part Time
Self-Employed
Home Maker
Student
Retired
Yrs employed at current position:
Yrs employed at current position:
Age:
Age:
Additional Borrower Information
Additional Co-Borrower Information
Have you had ownership interest in a property in the last 3 years?
Yes
No
Have you had ownership interest in a property in the last 3 years?
Yes
No
Type of property owned:
Type of property owned:
Title Held:
Title Held:
Do you intend to occupy the property as your primary residence?
Yes
No
Do you intend to occupy the property as your primary residence?
Yes
No
Income/Assets/Liabilities of Borrower
Income/Assets/Liabilities of Co-Borrower
Salary and Self Employment Income (Monthly):
Salary and Self Employment Income (Monthly):
All Other Income (Monthly):
All Other Income (Monthly):
Vested Interest in Retirement Fund:
Vested Interest in Retirement Fund:
Liquid Assets:
Liquid Assets:
Gift Assets:
Gift Assets:
Proceeds From Sale of Real Estate:
Proceeds From Sale of Real Estate:
Total Non Housing Payments (Credit Card, Installment Loans):
Total Non Housing Payments (Credit Card, Installment Loans):
Total Current Housing Expense (Mortgage Payment/Rent):
Total Current Housing Expense (Mortgage Payment/Rent):
Total Outstanding Debt (Credit Card, Installement Loans) Gross Amount:
Total Outstanding Debt (Credit Card, Installement Loans) Gross Amount:
If Refinance What is Payoff on Current Residence:
If Refinance What is Payoff on Current Residence:
Property Details
Address:
Sales Price:
City, State:
AL
AK
AZ
AR
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MH
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Estimated Value:
Zip Code:
Will This Property be Owner Occupied?
Yes
No
Number of Units:
The following information applies only to new Condo or PUD Projects:
Year Built:
No. of units in Project:
Year Aquired:
Is PUD or Condo Project 50% sold?
Yes
No
I have read and understand the terms and conditions and disclaimer documents. I understand that that submittal of this information does not constitute an agreement between myself and Abode Mortgage Services, Inc.
© 2006 Abode Mortgage Services, Inc.