Contact Information:
How did you hear about us?
I want to:
Purchase Price:
Loan Amount:
Borrower Married Unmarried
First Name:
Last Name:
SSN:
Date of Birth:
Home Phone:
Cell Phone:
Email Address:
Years of School:
Co-Borrower Married Unmarried
First Name:
Last Name:
SSN:
Date of Birth:
Home Phone:
Cell Phone:
Email Address:
Years of School:
Present Address:
Borrower
Own / Rent:
Street Address:
City:
State:
Zip Code:
Years at this address:
Co-Borrower
Own / Rent:
Street Address:
City:
State:
Zip Code:
Years at this address:
Previous Address:
Borrower
Own / Rent:
Street Address:
City:
State:
Zip Code:
Years at this address:
Co-Borrower
Own / Rent:
Street Address:
City:
State:
Zip Code:
Years at this address:
Subject Property:
Type of Property:
Street Address:
City:
Occupancy:
State:
Zip Code:
Monthly Housing Expense & Liabilities:
  Monthly Payments
Mortgage / Rent:
2nd Mortgage:
Property Taxes & Insurance:
Monthly Debt (Credit Cards, Auto Loans, Student Loans, etc)
Total:
Employment Information:
Borrower
Self Employed?
Name and Address of Employer:
Employer Name:
Job Title:
Employer Phone:
Street Address:
City:
State:
Zip Code:
Years on this Job:
Years in this industry:
Co-Borrower
Self Employed?
Name and Address of Employer:
Employer Name:
Job Title:
Employer Phone:
Street Address:
City:
State:
Zip Code:
Years on this Job:
Years in this Industry:
Previous Employer (If Employed In Current Position for Less Than Two Years):
Borrower
Self Employed?
Name and Address of Employer:
Employer Name:
Job Title:
Employer Phone:
Street Address:
City:
State:
Zip Code:
Years on this Job:
Years in this Industry:
Co-Borrower
Self Employed?
Name and Address of Employer:
Employer Name:
Job Title:
Employer Phone:
Street Address:
City:
State:
Zip Code:
Years on this Job:
Years in this Industry:
Gross Monthly Income:
Borrower
Base:
Bonus:
Commission:
Overtime:
Other:
Total:
Co-Borrower
Base:
Bonus:
Commission:
Overtime:
Other:
Total:
Assets - Checking, Savings, Gift:
Checking Accounts:
Savings Accounts:
Stocks & Bonds:
CD's & Money Markets:
Retirement Funds - 401(k), IRA, etc...
Gift Funds from a Relative:
Total Liquid Assets:
Declarations:
  Borrower Co-Borrower
Have you been declared bankrupt in the last 7 years? Yes No Yes No
Have you had a property foreclosed upon in the last 7 years? Yes No Yes No
Do you intend to occupy the property as your primary residence? Yes No Yes No
Are you presently delinquent or in default on any federal debt? Yes No Yes No
Have you owned any Real Estate in the last 3 years? Yes No Yes No
Are you a U.S. citizen? Yes No Yes No
Are you a permanent resident alien? Yes No Yes No
Authorize and Submit
I / We Authorize Newcastle Financial Group to obtain a consumer credit report containing my / our credit history.