Amerifinancial Home Mortgage, Inc.

Short Application
Property and Loan Information
Street:  
Property Address:
 
City, State, Zip:   
Loan Applied for:    V.A    Conventional    Other
   FHA    USDA/Rural
  Housing Service
Loan, Tax & Insurance Information: Amount Applied For: $    
Interest Rate:   Number of Months:  
Amortization Type :    Fixed Rate    Other
   GPM    ARM
 Purpose of Loan:
   Purchase    Construction    Other
   Refinance    Construction
        to permanent
Borrower Information
  First Name (Include Jr. or Sr.):  MI:   Last Name :
  Social Security Number:   DOB (mm/dd/yyyy):   img
  Home Phone:    Work Phone:
Employment Information :
Self Employed?   YesNo:     Years on Job:      Annual Income: $
  Income and Expenses :
  Monthly Expenses: $  Monthly Income: $    Credit:
  Assets and Liabilities :
  Total Assets : $  Total Liabilities : $  Net Worth : $
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This is an application for Joint credit. There will be a Borrower and a Co-Borrower.
By submitting this application, I give consent for my credit to be pulled.