Loan Application

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Mortgage Broker Input Form
California Secured Funding
Requested Loan Amount: $_____________
1901 S. Bascom Ave. #1060
Estimated Property Value $_____________
Campbell CA 95008
Property Description__________________
LOAN APPLICATION
BORROWER
CO-BORROWER
_______________________________________________________
________________________________________________________
Name
Name
Home Phone
(________) _______________________________
Home Phone
(________) _______________________________
Business Phone (________) _______________________________
Business Phone (________) _______________________________
_______________________________________________________
________________________________________________________
Property Address
Property Address
_______________________________________________________
________________________________________________________
Mailing Address
Mailing Address
_______________________________________________________
________________________________________________________
City, State, Zip
City, State, Zip
_______________________________________________________
________________________________________________________
Occupation or Profession if Self Employed
Occupation or Profession if Self Employed
_______________________________________________________
________________________________________________________
Current Employer
Current Employer
_______________________________________________________
________________________________________________________
Employment Address
Employment Address
Years on Job ______ Age _______
Years on Job ______ Age _______
SS#._________________________
SS#._________________________
Marital Status:
Married
Separated
Unmarried (includes single,
Marital Status:
Married
Separated
Unmarried (includes single,
divorced and widowed)
divorced and widowed)
I (we) live in the property being pledged for the subject loan.
Y
N
I (we) live in the property being pledged for the subject loan.
Y
N
Have you filed for bankruptcy in the past 12 months?
Y
N
Have you filed for bankruptcy in the past 12 months?
Y
N
If yes, what type of bankruptcy was filed? Chapter
7
11
13
If yes, what type of bankruptcy was filed? Chapter
7
11
13
Approximate date of filing __________________________________
Approximate date of filing ___________________________________
County where filed? _______________________________________
County where filed? ________________________________________
SOURCES OF INCOME
Monthly Amt
SOURCES OF INCOME
Monthly Amt
(List and identify each source separately)
(List and identify each source separately)
_____________________________________
________________
______________________________________
________________
_____________________________________
________________
______________________________________
________________
_____________________________________
________________
______________________________________
________________
_____________________________________
________________
______________________________________
________________
Total income Per Month
$ _______________
Total income Per Month
$ _______________
Applied Business Software, Inc. (800) 833-3343
[091359/Felix]
Loan Application
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