NH Manufactured Housing Loans
Credit Application
Licensed by nh banking department nmls 92195Applicant Information
Name:
Date of birth: / SSN: / Phone:
Current address:
City: / State: / ZIP Code:
OwnRent(Please circle) / Monthly payment or rent: / Years: Months:
Previous address (if not at current address for longer than 5 years):
City: / State: / ZIP Code:
OwnedRented(Please circle) / Monthly payment or rent: / Years: Months:
Employment Information
Current employer:
Employer address: / Years: Months:
Phone: / E-mail: / Fax:
City: / State: / ZIP Code:
Position: / Hourly Salary(Please circle) / Monthlyincome:
Profession: / Hours per week:
Previous employer(if not at current employer for longer than 5 years):
Address: / Years: Months:
Phone: / E-mail: / Fax:
City: / State: / ZIP Code:
Position: / HourlySalary(Please circle) / Monthlyincome:
Other Sources of Income
Description / Amount per month
Have you declared bankruptcy in the past 10 years?
If yes, explain:
Have there been any judgments, liens or foreclosures?
If yes, explain:
Have you ever applied for credit under another name?
If yes, explain:
Co-Applicant Information, if for a joint account
Name:
Date ofbirth: / SSN: / Phone:
Current address:
City: / State: / ZIP Code:
OwnRent(Please circle) / Monthly payment or rent: / Years: Months:
Previous address (if not at current address for longer than 5 years):
City: / State: / ZIP Code:
OwnedRented(Please circle) / Monthly payment or rent: / Years: Months:
Employment Information
Current employer:
Employer address: / Years: Months:
Phone: / E-mail: / Fax:
City: / State: / ZIP Code:
Position: / Hourly Salary(Please circle) / Monthlyincome:
Profession: / Hours per week:
Previous employer(if not at current employer for longer than 5 years):
Address:
Phone: / E-mail: / Fax:
City: / State: / ZIP Code:
Position: / HourlySalary (Please circle) / Monthlyincome:
Other Sources of Income
Description / Amount per month
Have you declared bankruptcy in the past 10 years?
If yes, explain:
Have there been any judgments, liens or foreclosures?
If yes, explain:
Have you ever applied for credit under another name?
If yes, explain:
Automobiles
Year: / Make: / Model:
Year: / Make: / Model:
Other assets
Description / Account no. / Amount
Credit Cards
Name / Account no. / Current balance / Monthly payment
Auto Loans
Auto loans / Account no. / Balance / Monthly payment
Other Loans, Debts, or Obligations
Description / Account no. / Amount
Manufactured home description
Park Name: / Address:
New or Pre-owned: / Number of Sides: / Manufacturer:
Year Built: / Model Name: / Serial Number:
Home Size: / Pre-owned Home Value: / Purchase Price:
Cash Down Payment: / Total Down Payment: / Insurance Premiums:
Extended Warranty: / Amount Requested: / Additional Features:
Do you wish to answer questions - applicant? / Do you wish to answer questions – co-applicant?
Sex: / Sex:
Marital Status: Single, Married, Separated? / Marital Status: Single, Married, Separated?
Ethnicity: Hispanic or Latino? / Ethnicity: Hispanic or Latino?
Race: / Race:
I authorize NH Manufactured Housing Loans to verify the information provided on this form as to my credit and employment history.
Signature of applicant / Date
Signature of co-applicant, if for joint account / Date
Fax completed application to NH Manufactured Home Loans: (603) 434-1149, or
e-mail to , or
mail to NH Manufactured Housing Loans, 192 bypass 28, Derry,N.H.03038
Phone: (888-201-2573)
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