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? Yes No *Marital status: Single Married *Number of Dependents *Ages of Dependents * Self Employed? Yes No * Current Employer * Start Date * Job Title * Gross Monthly Income Other Income Monthly $ Prior job (Need 2 years of employment history. Please include dates from when to when you were emplyed 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 If rent how much? * How long at this address?
Previous Address Information (if less than 2 years at current address) Previous Address City State Zip Code
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? Yes No Marital status: Single Married Does Co-Borrower have VA eligibility? Yes No Self Employed? Yes No Current Employer Start Date Job Title Gross Monthly Income Other Income Monthly $ Prior job (Need 2 years of employment history. Please include dates from when to when you were emplyed at each job.) Alimony/Child Support: Alimony Child Support N/A Amount $: Receive or Pay? Pay Receive N/A
Co-Borrower's Current Address Information Current Address: City: State: Zip Code: Do you own or rent? Rent Own If rent how much? Number of years at this address?
Co-Borrower's Previous Address Information (if less than 2 years at current address) Previous Address City State Zip Code
Assets * Own additional properties? Yes No * Amount in Checking: Amount in Savings: Any investment/retirement? Yes No Gift Money:
Type of Mortgage and Terms of Loan * * Mortgage Applied for: Cody Financial to advise Conventional VA FHA USDA/Rular Housing Service Purchase Price: * Residence Type: Primary Residence Secondary Residence Investment Property * Escrow: Yes No Property Address: Realtor Name: *Referred By (how did you hear about us)
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.
