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September 3, 2010
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Application for Mobile Home Financing WITHOUT LAND - Chattel Mortgage Loans
BORROWER INFORMATION
First Name:*
Last Name:*
Credit Rating:*
Excellent
Good
Fair
Poor
No Credit Established
Co-Borrower First Name:
Co-Borrower Last Name:
CB Credit Rating:
Excellent
Good
Fair
Poor
No Credit Established
CONTACT INFORMATION
Phone #:*
Alternate Phone #:
Email:*
Best Time to Contact:
Anytime
8 AM - Noon
Noon - 5 PM
5 PM - 9 PM
MOBILE HOME INFORMATION
Type of Mobile Home:*
Singlewide
Doublewide
Triplewide
Modular
MH Width:
MH Length:
What Year is the MH?:*
MH Location Type:*
Mobile Home Park
State, Federal, or Employer Owned Lot
Private Leased Lot
Indian or Tribal Land
Family Land I Do Not Own
Other
My Own Land NOT deeded or financed with the MH
Purchase Price:*
Down-Payment:*
5%
10%
15%
20%
>20%
State Where You Are Buying*:
Alabama
Arizona
Arkansas
California
Colorado
connecticut
Delaware
Florida
Georgia
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
maine
Maryland
massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
nevada
new hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
rhode island
South Carolina
South Dakota
Tennessee
Texas
Utah
vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Is the MH Already Setup?:*
Yes – The MH is currently set-up on the lot
No – The MH needs to be moved to the lot and set-up
Occupancy:*
All Applicants Will Live in the MH Full Time
One Applicant is a Co-Signer Only and Will NOT be Living in the MH
This is a 2nd Home or Vacation Home - Only Occupied Occasionally
A Family Member Will Live in the MH but Will Not Be on the Loan
This is an Investment Property or Rental Unit
ADDITIONAL INFORMATION
Proof of Income:*
Regular Paystubs and W-2 Forms
Workman's Compensation
Regular Paystubs and 1099's
Unemployment
Social Security
Bank Statements
Pension
Tax Returns
Self Employment
Cannot Verify My Income
Other
Comments or Questions:
Please be as thorough as possible with the information in this form as it will help in processing your application quickly. In the interest of security we do not collect Social Security Numbers or other critical data until we speak with you directly. Note: the security code at the bottom of this form is case sensitive.
Please enter the code shown above:
* Required
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