Financing

Borrower Information

Borrower's Name:*

Home Phone:

Marital Status:

Email Address:*

City, State, Zip:*

Years At Present Address:

If At this Address for less than 2 years, list previous:

Date of Birth:*

Other Phone:

Number of Children:

Present Address:*

Ownership Status

Monthly Payment:*

Borrower Employment

Employer:*

Position:*

Work Phone:*

Start date at previous employer:

End date at previous employer:

Number of Years:*

Monthly Income:*

If at present employer for less than 2 years, list previous:

Co-Borrower Information

Co-Borrower's Name

Home Phone:

Marital Status:

Email:

City, State, Zip:

Years at Present Address:

If At this Address for less than 2 years, list previous:

Date Of Birth:

Other Phone:

Number Of Children:

Present Address:

Ownership Status:

Monthly Payment:

Co-Borrower Employment

Employer:

Position:

Work Phone:

Start date at previous employer:

End date at previous employer:

Monthly Income:

Number of Years:

If at present employer for less than 2 years, list previous:

Miscellaneous Information

Borrower other income source:

Co-Borrower other income source:

Borrower child support received:

Co-Borrower child support received:

Have you ever been Sued?:*

Have you ever filed bankruptcy?:*

Have you ever had property foreclosed?:*

Desired Maximum Monthly Payment:

Name Of Financial Institution:

Savings Balance:

Military Length In Service (if applicable):

Military Rations (if applicable):

Military BAQ (if applicable):

Borrower other income amount:

Co-Borrower other income amount:

Borrower child support paid:

Co-Borrower child support paid:

If so, please explain and list dates:

Amount of cash available for down payment:

Checking Balance:

Military:

Military Rank (if applicable):

Military Base Pay (if applicable):

Military Other(if applicable):

I authorize Lighthouse Point Realty to pull a credit record on the Borrower and Co-Borrower listed.*