A.          Personal Information   Borrower: Work Phone: Co-Borrower: Work Phone: Present Address: Home Phone: Number in Household: Age of Children: B.        Employment Information     Employer     Address       Phone Number     Job Title     Length of Employment           Yrs.              Mos.         Yrs.               Mos. Gross Annual Income Gross Monthly Income     Combined Annual Income Combined Monthly Income     Other Income, Explain:               C.        Income & Asset Information       Monthly Yearly Borrower’s Base Pay     Co-Borrower’s Base Pay     Other Earnings (explain)     Pensions, Social Security, Retirement Income     Gross Income from Subject Real Estate     Net Income from Other Real Estate     Other     Total     D.        Banking Information         Name of Bank Address Type of Account Account Number Current Balance                                                         E.         Liabilities (credit cards, automobile loans, personal  loans, alimony, child support, etc.)         Name Account Number Original Amount Monthly Payment Current Balance                                                                                         F.         Housing Information   Mortgage Lender’s Name & Address:   Account Number:   Date of Purchase: Purchase Price: Original Mortgage Amount: Mortgage Balance: Interest Rate: Terms: Hazard Insurance Carrier & Address:   Account Number:                                             G.         Monthly Housing Expenses:   Principal & Interest   Real Estate Taxes   Hazard Insurance   Mortgage Insurance (if applicable)   2nd Mortgage (if applicable)   Common Charges   Total       I affirm that all the answers given in this application are correct and made for the purpose of obtaining credit.   This application is made for the purpose of obtaining credit, and I authorize Mutual Housing of Southwestern Ct. , Inc. to communicate with any person, firm, or corporation necessary, and to obtain any information as may be needed concerning the statements made in this application and agree that the application will remain the property of  Mutual Housing of Southwestern Ct., Inc.  whether or not the loan herein is granted.   INTERVIEWED BY:  ______________________________                   Date:  __________________   _________________________________                   _____________________________________ Borrower’s signature           Date                           Co-borrower’s signature            Date   _________________________________                   _______________________________________ Social Security             Date of Birth                         Social Security                Date of Birth