Loan Application - Phil Conzelman

Please use this form to begin the loan process.

Sales Price:	Loan Amount:
Down Payment %

Borrower:		Age:
Address:		Home Phone:
City:		Yrs At Address
Zip:		E-mail
Employer:		Work Phone:
Address:		Position:
City:		Yrs on Job:
Zip:
Co-Borrower:		Age:
Address:		Home Phone:
City:		Yrs At Address
Zip:		E-mail
Employer:		Work Phone:
Address:		Position:
City:		Yrs on Job:
Zip:
Marital Status: Married Unmarried Separated Other: (single, divorced, widowed)

Monthly Income:	Borrower:	Co-Borrower:
Salary:	$	$
Other:	$	$
Total:	$	$

Monthly Payments
Amount:	Paid to:	Amount:	Paid to:
$		$
$		$
$		$

Source of Down/Assets
Bank Name:	Acct#:	Balance:
Bank Name:	Acct#:	Balance:
Bank Name:	Acct#:	Balance:

Disposition of Current Residence
Do you Rent:	Yes No	$ per month:
Do you Own:	Yes No	Mtg Pmt:
Plan to Sell:	Yes No	Est Proceeds
Taxes, HOA, Ins.

I / we hereby authorize you to release to Phil Conzelman, for verification purposes, information concerning: Employment history, dates, title(s), income, hours worked, etc, banking (checking & savings) account of record, mortgage loan rating (opening date, high credit, payment amount, loan balance and payment). Any information deemed necessary in connection with consumer credit report for real estate transaction. This information is for the confidential use of this lender in compiling a mortgage loan credit report. A copy of this authorization may be deemed to be the equivalent of the original and may be used as a duplicate original.

	Phil Conzelman Realtor� 222 Fashion Lane, Suite 206 Tustin, CA 92780 (714) NEW-HOME (714) 639-4663 Fax: (714) 505-6019 E-mail: phil@homesyoucanbuy.com
Each office is independently owned and operated.