620 E. 5th Ave.
Mount Dora, FL 32757
352-383-3046



Experienced. Local. Lending.
Photo by: Doug Thompson, Mt Dora Olive Company


All personal information supplied will remain within our organization and will not be shared with any external entity unless prior permission is given. Your personal information will not be sold, distributed or published in any manner whatsoever.

Referred By:   Date:
Applicant’s Legal Name:     Co-Applicant's Legal Name:
Applicant's Social Security #:   Co-Applicant's Social Security:
Applicant's Date of Birth:   Co-Applicant's Date of Birth:
 
Married:
   
         
Current Address   Current Address
City: , FL   Zip:   City: , FL   Zip:
How Long: Yr       Mo   How Long: Yr       Mo
Own or Rent: Own       Rent   Own or Rent: Own       Rent
Monthly Payment:   Monthly Payment:
(If less than 2 years, please fill out previous address below.)
Current Address   Current Address
City: , FL   Zip:   City: , FL   Zip:
How Long: Yr       Mo   How Long: Yr       Mo
Own or Rent ~ Monthly Payment:   Own or Rent ~ Monthly Payment:
         
Other Property Owned? Yes       No   Monthly Payment:
         
CONTACT INFORMATION        
Home Phone:   Home Phone:
Work Phone:   Work Phone:
Cell Phone:   Cell Phone:
E-Mail :     E-Mail :
         
EMPLOYMENT        
Applicant     Co-Applicant  
Employer:   Employer:
Position:   Position:
How Long:   How Long:
Monthly Income (before taxes):   Monthly Income (before taxes):
Self Employed: Yes    No   Self Employed: Yes    No
Do you pay Alimony or Child Support? Yes    No   If yes, Monthly Payment:
         
ASSETS        
Applicant's Checking     Co-Applicant's Checking  
Bank:   Bank:
Balance:   Balance:
         
Applicant's Savings     Applicant's Savings  
Bank:   Bank:
Balance:   Balance:
         
Applicant's Investments/Retirement Funds:   Co-Applicant's Investments/Retirement Funds:
Investor:   Investor:
Balance:   Balance:
         
Investment: Primary Residence: 2nd Home:   What Price Range are you looking at: $
         
Funds Available for Down payment: 20% 10% 3.5% Foreign National requires 35%
         
Applicant's Signature:   Co-Applicant's Signature:
         
Comments :
       

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