"Painless" Online Loan Application

I(We) hereby apply for a loan of
$ to be repaid in months at interest

Email Address:

APPLICANT   CO-APPLICANT
Name of Applicant Name of Applicant
Social Security Number   Social Security Number
Telephone
Telephone
Present Address   Present Address
How long? Own? Rent?   How long? Own? Rent?
Previous Address   Previous Address
How long? Own? Rent?   How long? Own? Rent?
 
Employer's Name and Business Address   Employer's Name and Business Address
Business Phone   Business Phone
Position   Position
Number of Years   Number of Years
Gross Mo. Income   Gross Mo. Income
Previous Employer
(if less than 2 years)		   Previous Employer
(if less than 2 years)
Business Phone   Business Phone
Position   Position
Number of Years   Number of Years
Gross Mo. Income   Gross Mo. Income
 
DEBTS   ASSETS
Creditors Balance Monthly Payments
1)
2)
3)
4)
5)
6)
7)
8)
 
Name of Bank Account # Balance
1)
2)
3)
4)
5)
6)
7)
8)

By submitting this loan application, I/we hereby state that the information above is accurate and current to the best of my/our knowledge. I/We authorize Lawrence D. Elliott of Prudential California Realty, and its agents, to perform a preliminary evaluation of my/our qualification for a mortgage, and for this purpose, instruct any of them to obtain a credit report and verify other credit information.

By pressing SUBMIT, you agree that by providing your telephone number(s) , you give Lawrence D. Elliott or his representative(s) express permission to call you now and in the future.

 

 

 

 

 

 

 

 

 

 

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