| Borrowers Name: |
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CoBorrower Name: |
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| S. S. # |
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CoBorrower S.S.#: |
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| Home Phone: |
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Home Phone: |
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| Cell Phone: |
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Cell Phone: |
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| Email:* Required |
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Address: |
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| Address: |
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City: |
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| City: |
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State: |
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| State: |
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Zip Code: |
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| Zip Code: |
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Co-Borrower Date of Birth: |
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| Best time to call: |
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| Date of Birth: |
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| Number of dependents under 18: |
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Number of dependents under 18: |
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| Current Rental Amount: |
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Current Rental Amount: |
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| Lease Expires: |
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Lease Expires: |
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| Current Employer |
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Current Employer |
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| Hourly Rate: |
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Hourly Rate: |
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| Weekly Income:(Before Taxes) |
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Weekly Income: (Before Taxes) |
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| Do you pay Alimony or Child Support? If yes, please specify type and monthly amount. |
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Do you pay Alimony or Child Support? If yes, please specify type and monthly amount. |
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| Other Income per month: (Please specify amount of Alimony, Child Support, or other income you receive per month.) |
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Other Income per month: (Please specify amount of Alimony, Child Support, or other income you receive per month.) |
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| How long will you receive Alimony, Child Support or other income? |
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How long will you receive Alimony, Child Support or other income? |
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| Ever filed bankruptcy? (last 2 years.) |
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Ever filed bankruptcy?(last 2 years) |
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| If yes, When and Explain: |
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If yes, When and Explain: |
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| Discharge Date: |
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Discharge Date: |
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| Ever been evicted or foreclosed? |
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Ever been evicted or foreclosed? |
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| Felony or sex offender? |
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Felony or sex offender? |
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| If yes, please explain |
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If yes, please explain |
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| Please select an item. |
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| Property of interest:
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| Dold Rental property address. (if applicable):
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| Lot and/or subdivision location you are interested in:
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| Homes For Sale: |
Investment Homes |
New Homes |
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| Comments:
A value is required. |
| Are you interested in Land Contract or Rental property?
A value is required. |
| EVERY person that is age 18 or older, and will be living in the home, MUST complete an application. If any question is not applicable to you, please mark N/A. We will NOT process any application with missing information.
You may be asked to provide a copy of EACH:
*Driver’s license or photo ID *Last 30 days of pay stubs *Proof of ALL other sources of income
Applicant represents that all the above statements are true and correct and hereby authorizes verification of the above statements and
Information, including but not limited to the obtaining of a credit report and tenant history report and agrees to furnish additional information on request. Credit reports are obtained thru J. Powder Mortgage, Ltd., one of the Dold Companies.
I agree that Dold Investment Co. may terminate any agreement entered into on reliance of any misstatement made above.
Name:
Date:
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