Mortgage Loan Application...

General Information - Applicant and/or Co-Applicant

Applicant First Name:
Applicant Last Name:
SSN:
Email Address:
Home Phone:
Work Phone:

Co-Applicant First Name:
Co_Applicant Last Name:
SSN:
Email Address:
Home Phone:
Work Phone:

Street Address:
City:
State:	Zipcode:

Gross Income:

Note: Alimony, child support, or separate maintenance income need not be revealed if you do not wish to have it considered as a basis for repaying this obligation.
Applicant Employer:
Monthly Income Amount:
Position:
Years on the Job:
Years in Same Field:

Co_Applicant Employer:
Monthly Income Amount:
Position:
Years on the Job:
Years in Same Field:

Other Income Applicant:
Monthly Income Amount:
Other Income Co-Applicant:
Monthly Income Amount:
Total Gross Monthly Income Amount:

Assets

Cash Deposit (Types of Accounts)	Amount
1.
2.

Checking & Savings Accounts (Financial Institution)	Account #/Amount Deposited
1.	#: Amount:
2.	#: Amount:

Stocks and Bonds (Please describe)	Amount
1.	Amount:
2.	Amount:
3.	Amount:

Life Insurance	Face Amount
Policy With:	Amount:

Automobile Type	Estimated Value
1.	Value:
2.	Value:
3.	Value:

Other Assets (Please describe)	Estimated Value
1.	Amount:
2.	Amount:
3.	Amount:
4.	Amount:

Housing Expenses

Housing Expense Item	Monthly Payment
First Mortgage:	Amount:
Property Taxes	Amount:
Home Owners Insurance:	Amount:
Total Monthly Housing Expenses:	Amount:

Monthly Debt

Type of Liability:	Account Number:	Current Balance:	Monthly Payment:
1.
2.
3.
4.
5.
6.
7.

Type of Loan Requested

Loan Type:
Residence Type:
Property Type:
Loan Term:
Estimated Loan Amount:

The best time to contact me...

would be:

Your comments:

Important information about procedures for opening a new account:
To help the government fight the funding of terrorism and money laundering activities, Federal law requires all financial institutions to obtain, verify, and record information that identifies each person who opens an account.

What this means for you:
When you open an account, we will ask for your name, street address, date of birth, and other information that will allow us to identify you. We may also ask to see your driver's license or other identifying documents.

"I authorize Cherokee Bank and/or assigns to obtain my/our credit report for the purpose of determining credit worthiness. The information that is obtained is strictly confidential. By submitting this electronically, this is to be deemed to be the equivalent of the original."

NOTE: All information is submitted via a secure website.