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Express Mortgage Loan Application
Please print out this form, fill in the blanks, sign, date and fax to:
Bobbi Kirtland, FAX (513) 943-4409
BORROWER  
 
Name:                            
Address:                            
City:           State:     Zip:      
Home Phone Number: (            )       -        
Business Phone Number: (            )       -        
Social Security #:       -   -       Age:    
(If less than 2 yrs.):
Previous Address:                        
City:           State:       Zip:      
Employer                            
Address:                            
City:         State:       Zip:      
Time on job:                          
(If less than 2 yrs.)     
Employer                            
Address:                            
City:         State:       Zip:      
Time on job:                          
CO-BORROWER  
Name:                            
Address:                            
City:           State:     Zip:      
Home Phone Number: (            )       -        
Business Phone Number: (            )       -        
Social Security #:       -   -       Age:    
(If less than 2 yrs.):
Previous Address:                        
City:           State:       Zip:      
Employer                            
Address:                            
City:         State:       Zip:      
Time on job:                          
(If less than 2 yrs.)     
Employer                            
Address:                            
City:         State:       Zip:      
Time on job:                          
FINANCIAL INFORMATION          
         
MONTHLY INCOME
BORROWER CO-BORROWER
Base Pay                        
Overtime                        
Bonus                        
Commission                        
Child Support                        
Other                        
ASSETS
BORROWER CO-BORROWER
Checking                        
Savings                        
Socks/Bonds                        
401(k), IRA                        
Auto(s)                        
Personal Property                        
Home Equity                        
Other                        
OBLIGATIONS
BORROWER CO-BORROWER
Housing                        
Auto                        
Auto                        
Charges                        
Student Loans                        
Installment Loans                        
Other                        
Child Support                        
A FEW MORE QUESTIONS  
Have you ever filed bankruptcy?                
     If yes, when was it discharged?                
Will part of the down payment be borrowed?            
Are you a party to a law suit?                  
Are you obligated for child support?                
Are you a co-maker or endorser on a note?            
Do you have any outstanding judgements?            
AGREEMENT  
     I/we acknowledge that the information I/we have provided in this application is true and accurate to
the best of my/our knowledge.  I/we have given this information to a Crossmann Sales Consultant for
the purpose of obtaining credit which will be secured by a first mortgage.  I/we understand that the
information provided in this application will be verified by a designated mortgage company, and I/we
give permission to obtain report(s) about me/us for that purpose.
purpose.
                           
Borrower's Signature Date
                           
Co-Borrower's Signature Date
Please print out this form, fill in the blanks, sign and date and fax to:
Bobbi Kirtland, FAX (513) 943-4409

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