Loan Purpose
Fields with * are required. Your application will not be processed without the required information.
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Applicant |
Co-Applicant |
Name: (First, MI, Last)*
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Date of Birth*
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Name: (First, MI, Last)
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Date of Birth
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Social Security Number*
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Marital Status*
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Social Security Number
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Marital Status
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| Number of Dependants* (if none enter 0)
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Ages* (if none enter 0):
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Number of Dependants
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Ages:
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Present Street Address*:
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Present Street Address:
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City, State, & Zip*:
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Home Phone*:
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City, State, & Zip
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Home Phone:
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| Time At Current Address*
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*
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Mo. Rent / Mortgage*
$
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Time At Current Address
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Mo. Rent / Mortgage
$
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Previous Address: (if less than 3 yrs at current)
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Previous Address: (if less than 3 yrs at current)
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City, State, & Zip
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How Long
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City, State, & Zip
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How Long
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Name of Nearest Relative (not living with you)*
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Relationship*
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Name of Nearest Relative (not living with you)
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Relationship
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| Relative's Address*:
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Relative's
City, State*
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Relative's Address:
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Relative's
City, State
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| Relative's Phone*
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Relative's Phone
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Employment (3 Year History) |
Employment (3 Year History) |
Employer's Name*
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City, State*
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Employer's Name
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City, State
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| Job Title*
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Phone *
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Job Title
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Phone
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Gross Monthly Income*
$
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Hire Date*
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Gross Monthly Income
$
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Hire Date
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Source of other income
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Amount
$
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Source of other income
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Amount
$
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| Other Income: Alimony, child support or separate income need not be revealed, unless you want it considered for repayment of this credit request |
Previous Employer's Name
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City, State
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Previous Employer's Name
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City, State
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| Job Title
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Phone
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Job Title
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Phone
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Gross Monthly Income
$
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From:
To:
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Gross Monthly Income
$
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From:
To:
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Previous Employer 2 Name
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City, State
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Previous Employer's Name
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City, State
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| Job Title
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Phone
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Job Title
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Phone
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Gross Monthly Income
$
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From:
To:
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Gross Monthly Income
$
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From:
To:
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Credit References and Other Obligations |
Name of Bank (Checking)*
Account Number
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Balance*
$
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Name of Bank (Checking)
Account Number
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Balance
$
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Name of Bank (Savings)
Account Number
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Balance
$
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Name of Bank (Savings)
Account Number
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Balance
$
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| Alimony, Child Support, Child Care |
Amount
$
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Alimony, Child Support, Child Care |
Amount
$
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Information for Government Monitoring Information |
The following information is requested by the Federal Government for certain types of loans related to a dwelling in order to monitor the lenders compliance with equal credit opportunity, for housing and home mortgage disclosure laws. You are not required to furnish this information, but are encouraged to do so. The law provides that a lender may discriminate neither on the basis of this information, nor on whether you choose to furnish it. If you furnish the information please provide both ethnicity and race. If you choose not to furnish ethnicity, race or sex, under Federal regulations this lender is required to note the information on the basis of visual or verbal observation or surname. If you do not wish to submit the information please select the approiate choice from the drop down list below.
(Lender must review the above material to assure that the disclosure satisfy all requirements to which the lender is subject under law for the particular type of loan applied for.) |
| Applicant
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Co-applicant
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| Ethnicity:
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Ethnicity:
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Race:
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Race:
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| Sex:
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Sex:
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All of the statements made are true and correct. For the purpose of obtaining credit, the creditor is authorized to investigate my credit record, to obtain a credit report, employment and income reference, to obtain other such information. By typing your name and today's date in the space below you are granting McCants Mobile Homes permission to run your credit application and gather other information . |
Applicants Name:*
Today's Date:* |
Co-Applicants Name:
Today's Date:
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Communications Disclosure Form
Your credit application will be submitted to a lender (the "lender") for review. The lenders designated representative (or a person under their supervision, as appropriate) may communicate it's status or address other questions you may have about your application or the loan process. The retailer from whom you may purchase a home and it's sales consultations may assist you with matters associated with the transaction - for example: The type of home to purchase, options, site improvements, sales features that may impact your financing options, etc.
During the sales process, if there are questions that may impact the financing of your purchase, your sales consultations may conference or connect you and the appropriate representative(s) of the lender for your convenience.
Following the receipt of your credit application, a representative from the lender (or a person under their supervision, as appropriate) may contact you to discuss your application. Should you have any questions about your application, please contact the lender at the number provided.
By entering your name and date below, you acknowledge that you have read and understand the details provided, and also consent to the lender sharing the decision of your credit application and other necessary personal financial information with your retailer in order to facilitate your sales transaction and other purposes. You also acknowledge that you have personally completed the information on the application accurately.
Applicant Name*
Date*
Co-Applicant Name
Date
Dealership McCants Mobile Homes Name of Sales Person (if known)
This form must be electronically signed with Name and date or your application will not be processed. By entering your name and today's date to this form, you are agreeing that you have read and understand the above application and disclosure form.
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