Equal Housing Opportunity Graphics for Printing

than TWO years at one place If employed for LESS than TWO years at one place continue listing employers on a separate page.continue listing employers on a separate page. Borrower's SignatureDateBorrower's SignatureDate I authorize the HomeOwnership Center to research my I authorize the HomeOwnership Center to research my credit file with m y p ursuit of a loan to p urchase real estat e credit file with m y p ursuit of a loan to p urchase real estat e EQUAL HOUSING LENDER INCOME, CREDIT, SAVINGSBORROWERCO-BORROWER What is your current rent, NOT including utilities?$$ How long have you lived there?<br><br> Have you owned a home in the last three years?YesNoYesNo Are you married, single, divorced, widowed, separated?M S D W Sep M S D W Sep Have you ever filed Bankruptcy?YesNoYesNo If yes, when was it discharged? Part-time seasonal employment not listed before?YesNoYesNo How long in this field?/Approximate yearly income /$ /$ Do you receive Child Support or Alimony?YesNoYesNo Can you document this income?YesNoYesNo How long will it continue?/Monthly amount receive /$ /$ Monthly Income from Social Security/Disability/ Retirement/Death Benefits$$ Any other monthly income not listed before: Source:$$ LIABILITIESBORROWERCO-BORROWER Rate your credit: (ex. None, poor, good, etc.) Do you have any outstanding collections or judgements?YesNoYesNo If yes, approximate amount you still owe:$$ Monthly Child Care, Child Support or Alimony payments: ADDITIONAL INFORMATION (REQUIRED) Do you have a contract on a house at this time?YesNo Are you working with a real estate agent?YesNo Do you have access to the Internet?Yes No Email Address: _______________________________________________ Do you receive assistance from the Section 8Yes No rental assistance program?<br><br> Are you an U.S. veteran?Yes No Are you Foreign Born?Yes No How did you hear about our services? OTHER INFORMATION (OPTIONAL) Borrower: Ethnicity Co-Borrower: Ethnicity Hispanic or Latino: Yes NoHispanic or Latino: Yes No Race:Race: American Indian or Alaska Native_______ American Indian or Alaska Native_______ Asian_____Black or African American______Asian_____Black or African American______ Native Hawaiian or Other Pacifica Islander______Native Hawaiian or Other Pacifica Islander______ White_____ Other________________________White_____ Other________________________ Sex:Sex: Male_____ _ Female_____Male____ _ Female_____ Any Additional Information:<br><br>

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