Borrower's Info * * First Name: * Middle Initial or N/A if none: * Last Name: Suffix: * Date of Birth: * Social Security: * Phone Number: * Borrower's Email: * Are you US Citizen? US Citizen Permanent Resident Non Citizen Work Visa/Other *Marital status: Single Married *Number of Dependents *Ages of Dependents * Self Employed? Yes No * Current Employer * Start Date * Job Title * Gross Monthly Income Other Monthly Income Source of Other Monthly Income Prior job (Need 2 years of employment history) Start and End Dates you were employed at each job * Alimony or Child Support: Alimony Child Support N/A Amount $: * Receive or Pay? Pay Receive N/A * Do you have VA eligibility? Yes No
Current Address Information * Current Address * City * State * Zip Code * Do you own or rent? Rent Own Live rent free If rent how much do you pay? * How long at this address? * Have you owned a home in the past 3 years? Yes No
Previous Address Information (if less than 2 years at current address) Previous Address City State Zip Code How Long at Previous Address * Have you owned a home in the past 3 years? Yes No
Co-Borrower's Info If Applicable First Name: Middle Initial or N/A if none: Last Name: Suffix: Date of Birth: Social Security: Phone Number: Email: (must be different that borrower's) Is Co-Borrower a US Citizen? US Citizen Permanent Resident Non Citizen Work Visa/Other Marital status: Single Married Number of Dependents Ages of Dependents Self Employed? Yes No Current Employer Start Date Job Title Gross Monthly Income Other Monthly Income Source of Other Monthly Income Prior job (Need 2 years of employment history) Start and End Dates you were employed at each job Alimony/Child Support: Alimony Child Support N/A Amount $: Receive or Pay? Pay Receive N/A Does Co-Borrower have VA eligibility? Yes No
Co-Borrower's Current Address Information Current Address: City: State: Zip Code: Do you own or rent? Rent Own Live rent free If rent how much do you pay? Number of years at this address? Have you owned a home in the past 3 years? Yes No
Co-Borrower's Previous Address Information (if less than 2 years at current address) Previous Address City State Zip Code How Long at Previous Address
Assets * * Own additional properties? Yes No * Amount in Checking: Amount in Savings: Amount in investment/retirement accounts: Gift Money: * Source of funds for closing:
Type of Mortgage and Terms of Loan * * Mortgage Applied for: Cody Financial to advise Conventional VA FHA USDA/Rular Housing Service Estimated Purchase Price: * Residence Type: Primary Residence Secondary Residence Investment Property Property address that you are interested in: * Do you prefer to have your property taxes & homeowner's insurance included in your monthly payment: Yes No
Realtor Name: *Referred By (how did you hear about us) * Preferred method of communication: phone email text any of the above
Authorization By submitting I hereby authorize the Cody Financial Mortgage Services to order a consumer credit report. The information the Cody Financial Mortgage Services obtains is only to be used in the processing of my mortgage quote.
