Bank Free Financing Application This information is uploaded to a secure server, and is never sold or shared with anyone. It is used for the exclusive purpose of Applying for a home. We reserve the right to refuse any applicant if any of the following information provided herein is found to be false and/or incomplete. By submitting this application, you are hereby authorizing us to obtain a copy of your credit report in order to assist in evaluating your application and thereafter, to obtain and use in attempting to collect any payments, late fees, legal fees, or other charges from you. Furthermore, you are authorizing us to investigate employment, criminal, and credit history, along with references you are providing. Only Clean, Neat, Drug-Free people who Pay On-Time need apply!! Your Name * Phone Number 1 * Example: (xxx) xxx-xxxx Phone Number 2 Example: (xxx) xxx-xxxx Date of Birth * Your Email * you can enter more than 1 if needed Current Address * please include full address including zip code How Long At Current Address * Previous Address if you have lived at your current address for 2 years or less Social Security Number * example: xxx-xx-xxxx Drivers License Number * Employment Status * Un-employedSelf-employedPart timeFull time State * ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming Name, Address & Phone Number of Employer * Length of Time with Current Employer * Position with Current Employer * Income From Current Employer * please specify if this is hourly,weekly,monthly,etc. Expected Move Out Date Name, Address, & Phone Number of Prior Employer if with current employer for less than 2 years Current Living Situation * RentOwnOther Current Landlord Name & Phone Number if renting or other Name & Phone Number of Previous Landlord Have You Ever Been Evicted or Sued by a Landlord? YesNo If Yes, Please Explain Total Expected Number of Occupants 123456789 Name, Age, and Relationship of Occupants Animals Have You Ever Been Convicted of a Criminal Offense? * YesNo If Yes, Please Explain Have You Ever Filed for Bankruptcy? * YesNo Emergency Contact Info name, phone, address, etc... Reference 1 please include name, phone number, and relationship to provided references Reference 2 Reference 3 Submit Never submit passwords through Forms.