Mortgage Application

Please complete the below application and submit it. Once received, your Credit Union loan officer will process your application and grant you pre-approval, subject to verification of information. To speed up the process you may fax your required documents to (813) 649-3905.

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Fields with an asterisk (*) are required

Loan Amount Requested *

Repayment Method *

Credit Type *

Individual Credit

Joint Credit

If joint, fill out Joint Applicant/Guarantor section also

Applicant

Name *

Account Number *

Are you married? *

Current Address *

Address (Continued)

City *

State *

Zip *

How Long at this Residence?

Years *

Months *

Housing *

Rent

Own

Monthly Payment *

The proposed address is *

Esitmated Value *

Proposed Address *

Address (continued)

City *

State *

Zip *

Home Phone *

Work Phone

Other Number

Social Security *

Date of Birth *

Email address *

Employer Name *

Employer Address

Employer City

State

Zip

Department/Position

Years

Months

Gross Income *

Frequency *

^ Income from alimony, child support or separate maintenance payment need not be revealed if you do not choose to disclose it as income.

Other Income

Frequency

Joint Applicant / Guarantor (Fill out only if Joint Credit)

I understand that I am applying as Joint Applicant / Guarantor

Name *

Account Number *

Are you married? *

Current Address *

Address (Continued)

City *

State *

Zip *

How Long at this Residence?

Years *

Months *

Housing *

Rent

Own

Monthly Payment *

Home Number *

Work Number

Other Number

Social Security *

Date of Birth *

Email address *

Employer Name *

Employer Address

Employer City

State

Zip

Department/Position

Years

Months

Gross Income *

Frequency *

^ Income from alimony, child support or separate maintenance payment need not be revealed if you do not choose to disclose it as income.

Other Income

Frequency

Required documents to upload:

Proof of Income (two most recent pay stubs and previous year W-2(s) or two years of tax returns if self-employed).
Home owner’s insurance declaration page(s), Boundary survey, 2 months most recent bank statements (other than from PowerNet).

Upload Documents *

Drag and drop files here or Browse

Comments/Other

Signature *

Joint Applicant / Guarantor Signature *

By clicking on the Submit button below, I/we certify that the information herein is true and complete. I/we agree that inquiries may be made to verify information and that credit references or verification may be given based on inquiries from other parties. This offer is subject to the credit policies of the credit union. I/We understand that you shall retain this application whether or not it is approved.

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