Allanach Mortgage

General Information

^*Date Processed:

^*Is there a Co-applicant:

^*Purchase or Refinance:

Purchase
Refinance

^*Loan Amount Requested:

^*Loan Term Requested in years:

Interest Rate Requested:

Primary Applicant

^*Last Name:

^*First Name:

Middle Initial:

^*Social Security No (TIN):

^*Date of Birth:

^*Phone Number:

Cell Number:

^*E-mail Address:

If you do not have an email please put in amg@amg.com

Home Address

^*Address 1:

Address 2:

^*City:

^*State:

^*Zip:

Time at Current Residence:

Residence Type:

Rent
Own

Present Employer

^*Name:

^*Job Title:

^*Phone Number:

^*Employment Starting Date:

^*Gross Salary $:

Notice: Alimony, child support, or separate maintenance income need not be revealed if the Borrower (B) or Co-Borrower (C) does not choose to have considered for repaying this loan.

Other Income:

Income Source:

Co Applicant

^*Last Name:

^*First Name:

Middle Initial:

^*Social Security No (TIN):

^*Date of Birth:

^*Phone Number:

Cell Number:

^*E-mail Address:

If you do not have an email please put in amg@amg.com

Home Address

^*Address 1:

Address 2:

^*City:

^*State:

^*Zip:

Time at Current Residence:

Residence Type:

Rent
Own

Present Employer

^*Name:

^*Job Title:

^*Phone Number:

^*Employment Starting Date:

^*Gross Salary $:

Notice: Alimony, child support, or separate maintenance income need not be revealed if the Borrower (B) or Co-Borrower (C) does not choose to have considered for repaying this loan.

Other Income:

Income Source:

Credit And Asset Information

^*Liquid Assets (Cash, Savings, etc.) $:

Stocks, Bonds, Mutual Funds, etc. $:

^*Home Value (Real Estate, Personal Property) $:

Demographic Information of Borrower

The purpose of collecting this information is to help ensure that all applicants are treated fairly and that the housing needs of communities and neighborhoods are being fulfilled. For residential mortgage lending, federal law requires that we ask applicants for their demographic information (ethnicity, sex, and race) in order to monitor our compliance with equal credit opportunity, fair housing, and home mortgage disclosure laws. You are not required to provide this information, but are encouraged to do so. The law provides that we may not discriminate on the basis of this information, or on whether you choose to provide it. However, if you choose not to provide the information and you have made this application in person, federal regulations require us to note your ethnicity. sex, and race on the basis of visual observation or surname. The law also provides that we may not discriminate on the basis of age or marital status information you provide in this application.
Instructions: You may select one or more "Hispanic or Latino" origins and one or more designations for "race" If you do not wish to provide some or all of this information, select the applicable check box.

Borrower:

Ethnicity:
Hispanic or Latino

Mexican Puerto Rican Cuban

Other Hispanic or Latino - Enter origin:
Example: Argentinean, Colombian, Dominican, Nicaraguan Salvadoran, Spaniard, etc

Not Hispanic or Latino
I do not wish to provide this information

Sex:
Male
Female
I do not wish to provide this information

Co Borrower:

Ethnicity:
Hispanic or Latino

Mexican Puerto Rican Cuban

Other Hispanic or Latino - Enter origin:
Example: Argentinean, Colombian, Dominican, Nicaraguan Salvadoran, Spaniard, etc

Not Hispanic or Latino
I do not wish to provide this information

Sex:
Male
Female
I do not wish to provide this information

Special Instruction/Comments:

^*How you heard about us?

Give the authority to the credit union or its processing and whole sale partner Allanach Mortgage Group Corporation, NMLS# 2894 to access my/our credit. By accessing this credit we can make a more complete diagnosis of you credit qualification.

Note: "After 2:00 pm your mortgage request is considered received on the next business day. For Saturday and Sunday the request is considered received Monday unless Holiday".

Allanach Privacy Policy
Security Policy

Mortgage Work Sheet

General Information

Subject Property

Primary Applicant

Home Address

Present Employer

Co Applicant

Home Address

Present Employer

Credit And Asset Information

Demographic Information of Borrower

Security Policy