Annual Gross Income:  $

Can you provide proof of income?  Yes     No

Other Source of Income:  $

Monthly Expenses:  $ 

Down Payment:  $

How much of down payment is gift money?: $

Type of Property:  Single Family Home Townhome Duplex 3 Unit 4 Unit Condo: 1-4 Stories Condo: 5+ Stories

State where property is located:  Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Mississippi Missouri Montana Nebraska Nevada New Hampshire New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

Have you been steadily employed for more than 2 years?   Yes    No