Borrower

Co-Borrower (if different)

Full Name:*

Current Street Address:*

City, State and Zip:*

County:

Home Phone:*

Work Phone:

Email Address:

Social Security Number:*

Employers:

Position:*

Self-Employed?*

Yes No

Yes No

Length of Employment:*

Adjusted Gross Monthly Income:*

Total Liquid Asset:*

Date of Birth:*

Amount Requested:*

Type of Loan:*

Loan Term:*

If purchase, down payment
will come from:*

Gift Savings/Checking Stock 401(K)/IRA

This information needs to be filled out for property that is collateral for the loan

Property Type:

Street Address:

City, State and Zip Code:

County:

Property will be used for:

Primary Second/Vacation Investment

Estimated Value / Purchase Price:

If the loan type is a refinance, provide an estimated value; if the loan type is a purchase, provide a purchase price.

Yearly Taxes:

Yearly Homeowner's Insurance:

Monthly Condo Fees:

Will taxes be included in the payment?

Yes No (if No - must be lower than 80% LTV)

Purpose of Refinance:

Year Purchased:

Original Price:

Do you want to roll in the closing costs?

Yes No

Mortgage Balances

Other information - please describe:

By submitting this online application, the borrower authorizes Vertical Lend to
check such things as credit, business and employment status and histories.

For your records, please print this page before clicking Submit Application.