Credit and Loan Application | Town and Country Home Mortgage

First Name

Last Name

Marital Status

Age(s) of dependant(s)

How long at current address?

Current amount of rent? (purchases only)

Mailing Address (if different from current address)

Previous Address (if at current address less than 2 years)different from current address)

Employer Name

Employer Phone number

Employment Start Date

Are you employed by a family member?

Employer Address

Position At Work

Do you have ownership in the company?

Employer Name

Employer Phone number

Employer Address

Employment Start and End Date

Position At Work

Source of Income (Social Security, retirement, child support, etc.)

Amount of monthly income

Do you have a bankruptcy, foreclosure, or short sale in the past 7 years?

Military Service?

Do you pay alimony or child support?

Purchases Only - Are you related to the seller?

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