This is Americasfamilybanc Mortgage CREDIT APPLICATION. You can fill out the application online or print out this form and fax back to us at 619-697-4739. Once you have filled out this form completely, we will have an answer for you within two business day, if not sooner!
CREDIT APPLICATION
Married applicants can apply for an individual account. Please indicate if you want an individual account in your name or a joint account with another person. Notice: Applicant/Co-Applicant need not reveal income from alimony, child support or separate maintenance if such income is not to be considered as a basis for repaying the obligation. Please read the entire page and it's contents! Please complete the entire form.
LOAN INFORMATION
Please provide us with the following Loan information
Amount Requested: ($20,000 Minimum)	$20,000 to $30,000 $30,000 to $40,000 $40,000 to $50,000 $50,000 to $60,000 $60,000 to $70,000 $70,000 to $80,000 $80,000 to $100,000 $100,000 to $200,000 $200,000+
Loan Type:	Purchase a New Home Refinance existing Home 125% 2nd Mortgage Home Equity Loan Equity Line of Credit
APPLICANTS INFORMATION
Please provide us with the following contact information
First Name:
Last Name:
Middle Initial:
Street Address 1:
Street Address 2:
City:
State:	AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY
Zip/Postal Code:
Work Phone:
Home Phone:
Fax:
E-mail:
Please provide us with the following personal information
Years at current address:
Months at current address:
Social Security Number
Date of Birth:
Current Employer
Been at Current Employer for (Months/Years):
Employers Address:
Employers City/State/Zip:
Job Title
Gross Monthly Income:
Other Monthly Income:
Describe Other Monthly Income:
Bank Name (1):
Account Number:
Account Type:	Checking Savings Checking & Savings
Bank Name (2):
Account Number:
Account Type:	Checking Savings Checking & Savings
Resident Status:	Rent Own Other
Rent or Mortgage Amount:
I will have a Co-Applicant (please check here if this will be a joint application)
CO APPLICANTS INFORMATION
Relationship to Applicant
First Name:
Last Name:
Middle Initial:
Social Security Number
Age:
Current Employer
Been at Current Employer for (Months/Years):
Employers Address:
Employers City/State/Zip:
Job Title
Work Phone No:
Gross Monthly Income:
Additional Information:

PLEASE READ AND COMPLETE ALL INFORMATION BELOW
Consumer Loan Agreement The undersigned makes the above representations, which are certified correct, for the purposes of securing credit; and authorizes the financial institution to gather whatever credit and employment history it considers necessary and appropriate, and to give information concerning this transaction to others. The undersigned further understands, that we will retain this application whether or not it is approved and that it is the applicant's responsibility to notify the creditor of any changes of name, address or employment. I / We hereby certify under PENALTY OF PERJURY that this financial statement is a complete, true and correct statement. You are hereby authorized to reveal my (our) payment records to any legitimate credit grantor and/or credit reporting agency upon their request on my (our) loan and, or accounts. To acknowledge that you have read, understand and agree to the consumer loan agreement above, type "authorized" in the appropriate box below. ** If faxing application please sign your name **
Applicant's Approval (type "authorized"):
Date:
E-Mail:
Fax (include area code):
Phone (include area code):
Mail Address (on loan application):
Please fully review this form before submitting
If you would still prefer faxing the credit application to us you can do so by following this procedure: Type in the correct information in the application fields. Without selecting the "Send Form" button, print the application via your normal printing procedure, (usually a "print" button across the top or a selection in your "file" pull-down menu). Once you have printed the document, fax the completed and "signed" application to us at 619-697-4739.

---

Copyright (c) 2000 - 2005. All rights reserved. Reproduction in whole or in part in any form or medium without express written permission of Americaecenter is prohibited.