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Print this form then
mail, fax or call our office
and a loan officer will contact you promptly. Borrower Co-borrower Name________________________ Name________________________ Home Address________________ Home Address________________ ____________________________ ___________________________ Home Phone__________________ Home Phone__________________ SS#_________________________ SS#_________________________ Number of Dependents________ Number of Dependents________ Employer Name________________________ Name________________________ Address_____________________ Address_____________________ ____________________________ ____________________________ Work Phone__________________ Work Phone__________________ Years Employed______________ Years Employed______________ Income Gross Monthly Income________ Gross Monthly Income________ Gross Monthly Debt _________ Gross Monthly Debt__________ I Hereby authorize Southern Horizon Mortgage to order a consumer credit report and verify other credit information, including past and present mortgage and landlord references. It is understood that a photocopy of this form will also serve as authorization. The information the lender obtains is only to be used in processing of my application for a mortgage loan.
Privacy Act Notice: This information is used by the agency collecting it in determining whether your qualify as a prospective mortgagor under its program. It will not be disclosed outside the agency except to your employer(s) for verification of employment, bank accounts for verification of deposits, stock holdings and other set balances as required and permitted by law. You do not have to give us this information, but if you do not, your application for approval as a prospective mortgagor or borrower may be delayed or rejected. The information requested in this form is authorized by Title 38. USC Chapter 37 (if VA); by 12 USC Section 1701 et.seq. (if HUD/FHA); AND Title 42 USC 1471 et.seq. Or & USC 1921 et.seq.
________________________________ _____________________________ Borrower Date Co-Borrower Date ________________________________ _____________________________ Sales Representative Phone Number |