Summary of Data Needed for Purchase Loan

Property Address:

City, State ZIP:

Purchase Price: $

Down Payment: $

Are you willing and able to document your Income? Yes or No

Are you willing and able to document your Assets? Yes or No

Monthly HOA Dues (if any): $

Occupancy: Owner-occupied or Non-owner occupied (rental/investment) or 2nd-home/Vacation

Type of Property: Condo or Townhome or Single-family or Multi-family

Borrower Name:

Marital Status:

Citizenship:

Birth date:

Current Address:

City:

State:

Zip:

How long at this address:

Home phone:

Work phone:

Borrower Name:

Marital Status:

Citizenship:

Birth date:

Current Address:

City:

State:

Zip:

How long at this address:

Home phone:

Work phone:

Gross income (before any deductions): $

Type of income: Salary/Wages or Commission

Other income: $

Source of other income (i.e. bonuses, rentals):

Name of employer:

Position/Job title:

How long with current employer?

Gross income (before any deductions): $

Type of income: Salary/Wages or Commission

Other income: $

Source of other income (i.e. bonuses, rentals):

Name of employer:

Position/Job title:

How long with current employer?

Cash in bank:

Mutual funds:

Stocks:

Retirement accounts:

Proceeds from sale of your current home:

Cash in bank:

Mutual funds:

Stocks:

Retirement accounts:

Proceeds from sale of your current home:

Current rent or house payment: $

(Total MINIMUM monthly payment for each)

Credit card debt: $

Student loans: $

Vehicle loans: $

Other loans: $

Current rent or house payment: $

(Total MINIMUM monthly payment for each)

Credit card debt: $

Student loans: $

Vehicle loans: $

Other loans: $

I authorize KRC Group Inc / Steve Rumberg to obtain a consumer credit report containing my credit history.

Social Security Number:

Signature:

I authorize KRC Group Inc / Steve Rumberg to obtain a consumer credit report containing my credit history.

Social Security Number:

Signature: