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How did you hear about us?
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Loan Purpose?
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Applicant Name?
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Social Security #?
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Date of Birth?
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Marital Status?
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Do you rent or own?
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Monthly Payment?
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Current Address, City, State and Zip Code?
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How long have you lived here? If less than two years, please provide previous address.
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Previous Address, City, State and Zip Code?
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Home Phone #?
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Cell Phone #?
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Email Address?
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Employer Name and Address, City, State and Zip Code?
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Self Employed?
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Work Phone #?
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Position with Company?
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Monthly Income?
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# of Years at Employer?
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If employed less than 2 years, please provide previous employer.
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Work Phone #?
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Position with Company?
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Monthly Income?
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Do you receive additional income? (Alimony,Child Support, Pension, Retirement, Social Security, Disability, Second Job, Other)
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Amount?
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# of Dependents?
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Banking Institution Name?
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Type of Account? (Checking, Savings, Money Market)
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Assets? (401K, IRA, Mutual Funds, Stocks, Bonds, Retirement Fund, Life Insurance)
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Current Value?
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Have you filed a bankruptcy within the past 7 years? If yes, Chapter 7 or Chapter 13?
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Discharged? Yes, No or Dismissed.
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Are there any outstanding judgments against you?
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Amount?
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Are you obligated to pay child support or alimony?
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Monthly Amount?
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Property Address Purchasing or Refinancing?
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Occupancy Type? (Owner Occupied, Non-Owner Occupied, Vacation Home)
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Property Type? (Single Family, New Construction, Condominium, Townhouse)
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Property Value?
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Amount Owed?
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Interest Rate?
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Do you own additional real estate?
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Would you like to apply with a co-applicant? If yes, please submit this application and enter a separate application for the co-applicant.
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Do you authorize Elite Mortgage Lending, LLC to obtain a credit report for the purpose of determining your qualification for a home mortgage loan?
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