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Mortgage Application
REAL ESTATE
Financial Information Sheet
Borrower Information:
Borrower (Full Name):
Date of Birth:
(ex. dd/mm/yyyy)
Soc. Security #:
Residence Phone #:
Business Phone #:
Present Address:
City:
State/Province:
Zip Code/Postal Code:
E-mail Address
Years at Present Address:
Rent $
/month
or
Own $
Previous Address:
City:
State/Province:
Zip Code/Postal Code:
Marital Status:
Married
Separated
Unmarried
(including single, divorced, or widowed)
 
Occupation:
(Position & Title)
# of years:
Place of Employment:
(Name & Address)
Previous Employer:
(Name & Address)
Co-Borrower Information:
Co-Borrower (Full Name):
Date of Birth:
(ex. dd/mm/yyyy)
Soc. Security #:
Residence Phone #:
Business Phone #:
If same as borrowers address
Present Address:
City:
State/Province:
Zip Code/Postal Code:
E-mail Address
Years at Present Address:
Rent $
/month
or
Own $
If same as borrowers address
Previous Address:
City:
State/Province:
Zip Code/Postal Code:
Marital Status:
Married
Separated
Unmarried
(including single, divorced, or widowed)
Occupation:
(Position & Title)
# of years:
Place of Employment:
(Name & Address)
Previous Employer:
(Name & Address)
Gross Annual Income:
Borrower
Co-Borrower
Self-Employed ?
Yes
No
Yes
No
Base Salary:
$
$
Overtime:
$
$
Bonuses:
$
$
Commissions:
$
$
Dividends:
$
$
Net Rental Income:
$
$
Other:
$
$
Total:
$
$
Do You Intend To Occupy This Property ?
Yes
No
Number of Children:
Ages:
Other Dependents:
Assets:
Checking:
$
Bank:
$
Bank:
Savings:
$
Bank:
$
Bank:
Credit Union:
$
Bank:
Stocks:
$
Bonds:
$
Life Insurance:
$
Present Residence (If Owned):
Market Value:
$
Morg. Value:
$
Lender:
Other Assets (Specify):
Liabilities:
(List outstanding obligations including auto loans, mortgage payments,credit cards,
personal loans, and all other loans.)
Type
Creditor's Name
Unpaid Balance
Due Date
Monthly Payment
$
$
$
$
$
$
Total:
$
$
Additional Monthly Obligations:
Alimony:
$
Child Support:
$
Child Care:
$
Are There Any Judgements or Lawsuits Present?
Yes
No
Amount:
$
Is Any Part of the Down Payment or Settlement Costs
Being Obtained From a Source Other Than From Assets
Listed Above?
Yes
No
I hereby give my consent to have my credit report secured
from any credit reporting agency which you designate.
Yes
No
Nostalgic Home Realty
Guaranteed Oregon and Washington Real Estate Home Sales 503-493-3200