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Mortgage Application Information - Required Fields *

Return to PERA Strategies Forms | Download print version (333K PDF)


  Client Information
Name:
Salary:
Client SS:
DOB:
Employer:
Work Phone:
Work HR Phone:
Hire Date:
 
Spouse Information
Name:
Salary:
Client SS:
DOB:
Employer:
Work Phone:
Work HR Phone:
Hire Date:
Residence Information
How Long:
Est. Value:
Est. Equity:
Address:
City, State, Zip:
Phone Numbers
Home:
Mobile:
Other:
Fax:
Objectives
 
Debt Balance Pmt $ Rate % Notes
Est. Debt Totals    
 
Notes:  
  I authorize IIG, Inc. and its affiliated Brokers to verify the information provided on this form such as current and past employment, assets, bank reserves, and verification of mortgage or rental history. I also authorize IIG, Inc. and its affiliated Brokers. to order a consumer credit report. I understand that my credit scores will be disclosed to me under the Fair Credit Act and the information the lender uses is only to be used in the processing of my Application for a mortgage loan under dept. of HUD Privacy act.
   
Applicant's Full Name:
 (Acts as Signature)
Date:
 
Co-Applicant's Full Name:
 (Acts as Signature)
Date:
 
Disclosure
 

I have read and agree to these terms. *

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Securities and advisory services offered through VSR Financial Services, Inc. a Registered Investment Adviser and Member FINRA/SIPC.
VSR Financial Services, Inc.does not provide Tax or Legal Services.
Financial Plans offered through Integrated Investment Group, Inc. IIG, Inc. is independent of VSR Financial Services.
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