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February 4, 2012
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Application to REFINANCE your Mobile Home in a Park, on a Leased Lot, Land you own separately, or on Family Land
(any situation where the land will not be financed with the MH)
BORROWER INFORMATION
First Name:*
Last Name:*
Rate Your Credit:*
Excellent
Good
Fair
Poor
No Credit Established
Credit Score(s) (if known):
Co-Borrower First Name:
Co-Borrower Last Name:
CB Credit:
Excellent
Good
Fair
Poor
No Credit Established
CB Credit Score(s) (if known):
MH Address:*
City:*
State*:
Alabama
Arizona
Arkansas
California
Colorado
Delaware
Florida
Georgia
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maryland
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
South Carolina
South Dakota
Tennessee
Texas
Utah
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Zip Code:*
CONTACT INFORMATION
Phone #:*
Alternate Phone #:
Email:*
Best Time to Contact:
Anytime
8 AM - Noon
Noon - 5 PM
5 PM - 9 PM
MOBILE HOME INFORMATION
Type of Mobile Home:*
Singlewide
Triplewide
Doublewide
Modular
What Year is Your MH?:*
Purpose of the Loan?:*
Lower My Rate and Payments
Debt Consolidation
Do Home Improvements
Get Cash Out
Lower the Number of Years on My Loan
Remove My Ex-Spouse from the Loan
Current Interest Rate:
Current Payment:
Lot Rent (if any):
Occupancy:*
All Applicants Live in the MH Full Time
One Applicant is a Co-Signer Only and Will NOT be Living in the MH
This is a 2nd Home or Vacation Home - Only Occupied Occasionally
A Family Member Lives in the MH but Will Not Be on the Loan
This is an Investment Property or Rental Unit
Payoff Amount:*
Desired Loan Amount:*
Current Lender:
ADDITIONAL INFORMATION
Proof of Income:*
Regular Paystubs and W-2 Forms
Workman's Compensation
Regular Paystubs and 1099's
Unemployment
Social Security
Bank Statements
Pension
Tax Returns
Self Employment
Cannot Verify My Income
Other
Comments or Questions:
Please be as thorough as possible with the information on this form as it will help to process your loan quickly. In the interest of security we do not collect Social Security Numbers or other critical data until we speak with you directly. Please note the security codes below are case sensitive.
Please enter the code shown above:
* Required
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