HOUSE APPLICATION
  1. There is a $20 application fee which must be paid BEFORE this application is processed. This must be paid by cash or money order. NO personal checks will be accepted!
  2. All adults who will be living in the house must fill out and sign this application.
  3. Answer all questions truthfully. All information will be carefully checked. False information will result in Automatic Rejection of this application. If you have questions, call our office.

Address of house you are applying for _____________________________________________________

APPLICANT

Full Name (First M.I. Last) _______________________________

Date of Birth __________ Social Security __________________

Phone (Day) (_____)_______________ (Eve) (_____)__________

# of People Who Will Live in House ____________________

In Case of Emergency Contact:_________________________

CO-APPLICANT

Full Name (First M.I. Last) __________________________

Date of Birth ________ Social Security __________________

Phone (Day) (_____)___________ (Eve) (_____)__________

# of People Who Will Live in House ___________________________

In Case of Emergency Contact:__________________________________

PRESENT ADDRESS Own _____ Rent _____

Street ______________________________________Apt. No. _______

City _____________________ State _________ Zip _______________

Number of years at present address ___________________________

Name of owner ______________________________________

Phone # of owner (_____)____________________________________

WHY ARE YOU MOVING? ____________________________________

__________________________________________________________

PRESENT ADDRESS Own _____ Rent _____

Street ______________________________________Apt. No. _______

City _____________________ State _________ Zip _______________

Number of years at present address ___________________________

Name of owner ______________________________________

Phone # of owner (_____)____________________________________

WHY ARE YOU MOVING? ____________________________________

__________________________________________________________

LAST ADDRESS Own _____ Rent _____

Street ______________________________________Apt. No. _______

City _____________________ State ________ Zip ________________

Number of years at present address ___________________________

Name of owner _____________________________________________

Phone # of owner (_____)____________________________________

WHY DID YOU MOVE? _______________________________________

__________________________________________________________

LAST ADDRESS Own _____ Rent _____

Street ______________________________________Apt. No. _______

City _____________________ State ________ Zip ________________

Number of years at present address ___________________________

Name of owner _____________________________________________

Phone # of owner (_____)____________________________________

WHY DID YOU MOVE? _______________________________________

__________________________________________________________

EMPLOYMENT INFORMATION

Name of Employer __________________________________________

Street __________________________ Phone (____)_______________

City _____________________ State ________ Zip ________________

Title______________________ Type of business _________________

Number of years at this job _____________ Self employed_________

EMPLOYMENT INFORMATION

Name of Employer __________________________________________

Street __________________________ Phone (____)_______________

City _____________________ State ________ Zip ________________

Title______________________ Type of business _________________

Number of years at this job _____________ Self employed_________

Previous employer

Name of Employer __________________________________________

Street __________________________ Phone (____)_______________

City _____________________ State ________ Zip ________________

Title______________________ Type of business _________________

Previous employer

Name of Employer __________________________________________

Street __________________________ Phone (____)_______________

City _____________________ State ________ Zip ________________

Title______________________ Type of business _________________

WEEKLY INCOME BEFORE TAXES

MONTHLY HOUSING EXPENSES

 

APPLICANT

CO-APPLICANT

TOTAL

Rent/House Payment

 

Base Income

 

 

 

House/Renter's Insurance

 

Overtime

 

 

 

Utilities

 

Bonuses

 

 

 

Other

 

Other*

 

 

 

 

 

Total

 

 

 

Total Monthly Payment

 

DESCRIBE OTHER INCOME

`Applicant/Co-Applicant

*Alimony, child support, or separate maintenance income need not be revealed if the Applicant or Co-Applicant does not wish to have it considered as a basis for repaying this loan.

Monthly Income

 

 

 

 

 

 

APPLICANT AND CO-APPLICANT MUST BOTH ANSWER THESE QUESTIONS

ANSWER "YES" or "NO". If "Yes", explain. If you have any questions about this section, please call our office.

Applicant

Co-Applicant

Explanation

Have you declared bankruptcy in the last 2 years?

 

 

 

Have you ever been evicted or asked to leave a property for any reason?

 

 

 

Do you have any unpaid JUDGEMENTS or COLLECTIONS?

 

 

 

Have you ever been involved in a lawsuit as PLAINTIFF or DEFENDANT?

 

 

 

Have you been convicted of a felony or misdemeanor in the last 5 years? (Except minor traffic violations)

 

 

 

Have you ever had a home foreclosed on?

 

 

 

Have you been pre-qualified to purchase a property by a bank or mortgage broker?

 

 

 

Would you be willing to attend low-cost home buyer’s classes?

 

 

 

Do you intend to BUY this home?

 

 

 

 

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Please List Checking Account Numbers and Approximate Balances

Please List Savings Account Numbers and Approximate Balances

Account Number

Approximate Balance

Account Number

Approximate Balance

 

$

 

$

 

$

 

$

 

$

 

$

 

$

 

$

Please List All Types of Remodeling Work You Have Performed

Please list owner names and addresses of any major remodeling jobs you have completed

Owner’s Name

Address of Remodeled Property

Type of Work Done

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

I certify under penalty of legal action that I have answered all of the above questions to the best of my ability. I give permission to ____________________________ to use the provided information for purposes of verifying my qualifications to lease this property.

Applicant’s Signature

Date

Co-Applicant’s Signature

Date



This form is courtesy of:

http://www.jerushomes.com