(or Individual Taxpayer Identification Number)
(Single, Divorced, Widowed, Civil Union, Domestic Partnership, Registered Reciprocal Beneficiary Relationship)
Please list the number of dependents and their ages.
If applicable
If applicable
Include extension if applicable
Please include street number and name, unit number (if applicable), city, state, ZIP code
Leave blank if not renting
Leave blank if not applicable
Leave blank if same as current address
Leave blank if not applicable
Other Sources of Income Include: Alimony, Automobile Allowance, Boarder Income, Capital Gains, Child Support, Disability, Foster Care, Housing or Parsonage, Interest and Dividends, Mortgage Credit Certificate, Mortgage Differential Payments, Notes Receivable, Public Assistance, Retirement (i.e. Pension, IRA), Royalty Payments, Separate Maintenance, Social Security, Trust, Unemployment Benefits, VA Compensation, Other
Checking, Savings Money Market, Certificate of Deposit, Mutual Fund, Stocks, Stock Options, Bonds, Retirement (e.g. 401k, IRA), Bridge Loan Proceeds, Individual Development Account, Trust Account, Cash Value of Life Insurance (used for the transaction)
Revolving Credit (i.e. Credit Cards), Installment (i.e. car, student loan, personal loans), Open 30-Day (balance paid monthly), Lease (not real estate), Other
Alimony, Child Support, Separate Maintenance, Job Related Expenses, Other
If not included in Monthly Mortgage Payment
If you will occupy the property, will you set aside space within the property to operate your own business? (e.g., daycare facility, medical office, beauty/barber shop)
Is the property a manufactured home? (e.g., a factory built dwelling built on a permanent chassis)
Complete if the property is a 2-4 Unit Primary Residence or an Investment Property
Examples include: Relative, Employer, Unmarried Partner, Religious Nonprofit, Community Nonprofit, Federal Agency, State Agency, Local Agency, Other
If Yes, complete the next two lines