McKeown Real Estate, Sales, Rentals, Appraisals, and Auctions

Borrower's SS# (no dashes or spaces please...)

By giving us your social security number, you are giving us the right to obtain your credit report. Please be aware we can not give you a qualifying letter without this information. If you are uncomfortable releasing this information over the internet, please call our office at 570.424.2762.

Borrower's birth date -- mm/dd/yy

Dependents

Age of Borrower's Children

Employment Information:

Position/Title
Employer

Gross Monthly Salary $

Employment Start Date -- mm/dd/yy

Are you - Salaried Self-Employed

About Co-Borrower (if any)...

Name of Co-Borrower:

First Name	Middle
Last Name
Mailing Address
Address (cont.)
City
State/Province	Zip/Postal Code
Work Phone
Home Phone
FAX
E-mail
URL

Co-Borrower's SS# (no dashes or spaces please...)

Co-borrower's birth date -- mm/dd/yy

Age of Co-Borrower's Children

Age of Co-Borrower's Dependents

Co-Borrower's Employment Information:

Position/Title
Employer

Co-Borrower's Gross Monthly Salary $

Co-Borrower's Employment Start Date -- mm/dd/yy

Is Your Co-Borrower - Salaried Self-Employed

Money available for down payment and closing cost total $

Monthly mortgage payment you feel comfortable affording $

Yes, I would like a good faith estimate of closing costs.