Allanach Mortgage Group

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 $:

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 $:

Other Income:

Income Source:

Credit And Asset Information

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

Stocks, Bonds, Mutual Funds, etc. $:

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

INFORMATION FOR GOVERNMENT MONITORING PURPOSES

The following information is requested by the Federal Government for certain types of loans related to a dwelling in order to monitor the lender's compliance with equal credit opportunity, fair housing and home mortgage disclosure laws. You are not required to furnish this information, but are encouraged to do so.

Borrower: I don't wish to furnish this information

Ethnicity: Hispanic or Latino Not Hispanic or Latino

Race: American Indian or Alaska Native
Asian
Black or African American
Native Hawailan or other Pacific Islander
white

Sex: Male Female

Co Borrower: I don't wish to furnish this information

Ethnicity: Hispanic or Latino Not Hispanic or Latino

Race: American Indian or Alaska Native
Asian
Black or African American
Native Hawailan or other Pacific Islander
white

Sex: Male Female

Special Instruction/Comments:

Allanach Privacy Policy
Security Policy

In partnership with your credit union

Mortgage Application

General Information

Subject Property

Primary Applicant

Home Address

Present Employer

Co Applicant

Home Address

Present Employer

Credit And Asset Information

INFORMATION FOR GOVERNMENT MONITORING PURPOSES

Security Policy