North American Savings Bank
Borrowers Information Worksheet
Attn: “The Alderman Team”
Borrower’s Information
Name______Social Security # ______
Date of Birth______Years of School #______Dependents #______Ages______
Married______Unmarried______Separated_____ Home #______Cell#______
Address______City______State______Zip______
Rent_____ or Own______No. of years/months______Monthly Payment $______
Mortgage Balance$______Value of Home $______
Mortgage Co. Name______
Landlord Name______Phone #______
*If less than 2 Years at current address please complete the information below:
Previous Address______City______State______Zip______
Rent_____ or Own_____ No. of years/months______Monthly Payment $______
Mortgage Co. Name______
Landlord Name______Phone #______
Co-Borrower’s Information
Name______Social Security #______
Date of Birth______Years of School #______Dependents #______Ages______
Married______Unmarried_____ Separated______Home #______Cell #______
Address______City______State______Zip______
Rent _____ or Own _____ No. of years/months______Monthly Payment $______
Mortgage Balance $______Value of Home $______
Mortgage Co. Name______
Landlord Name______Phone #______
*If less than 2 years at current address please complete the information below:
Previous Address______City______State______Zip______
Rent_____ or Own______No. of years/months______Monthly Payment $______
Mortgage Co. Name______
Landlord Name______Phone #______
Employment Information
Borrower’s Current Employer
Employer’s Name______Phone #______
Address______City______State______Zip______
Hire Date______Job Title______Years in Profession #______
HR Contact and Phone Number ______
Salary Information
Base Salary $______(per month, year or hourly) Average # of hours per week______
Overtime $______Commission $______Bonus $______Self Employed?______
* If less than 2 years at current employer please complete the information below:
Previous Employer’s Name______Phone #______
Address______City______State______Zip______
Dates Worked/ From______To______Position______Salary $______
Co-Borrower’s Current Employer
Employer’s Name______Phone #______
Address______City______State______Zip______
Hire Date______Job Title______Years In Profession #______
Human Resources Contact and Phone Number ______
Salary Information
Base Salary $______(per month, year or hourly) Average # of hours per week______
Overtime $______Commission $______Bonus $______Self Employed? ______
* If less than 2 years at current employer please complete the information below:
Previous Employer’s Name ______Phone #______
Address______City______State______Zip______
Dates Worked/ From ______To______Position______Salary______
*If additional room is needed to cover a full two year work history, please attach a separate paper.
Other Monthly Income - Received by: Borrower______Co-Borrower______
Monthly Amount $______How Long will income continue?______
Source of Income: (Child Support/ Alimony/ Other)______
Bank/ Asset Information
Bank Name______
Balances: Checking $______Savings $______Money Market $______
IRA $______CD $______CD $______
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Bank Name______
Balances: Checking $______Savings $______Money Market $______
IRA $______CD $______CD $______
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Bank Name______
Balances: Checking $______Savings $______Money Market $______
IRA $______CD $______CD $______
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Bank Name______
Balances: Checking $______Savings $______Money Market $______
IRA $______CD $______CD $______
Other Assets
Stocks/Bonds $ ______Retirement Fund/401K $______
Retirement Fund/401K $______Other______
Other Real Estate Owned
Address______City______State______Zip______
Rental Property? Yes______No______Monthly Rent $______Payment $______
Mortgage Balance $______Value $______
Mortgage Co. Name______
Where are you obtaining funds for down payment & closing costs from?
Savings/ Amount $______Gift/ Amount $______Other/ Amount $______
Are you selling your present home? (Yes/ No) Estimated proceeds from Sale: $______
Is purchase of new home contingent upon the sale of present home? Yes______No______
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Do you pay child support or alimony? ______Monthly Amount?______
Have you ever filed bankruptcy?______When?______Any known credit problems?______
Brief explanation for above:______
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Are you a U.S. Citizen?______Property will be: Owner Occupied______Investment______
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Are you working with a Real Estate Agent?______Are you under contract to purchase?______
Realtor Name______Company______Phone No.______
New property address______City______St______Zip______
Estimated Purchase Price $______Estimated Loan Amount $______
Est Closing Date?______I am most interested in: ______Fixed Rate ______Adjustable Rate
Additional Information Needed for Refinances
Est. Value of Property $______Taxes $______Insurance $______Month Due?______
Month/Yr purchased ______Original Purchase Price $______Year Built______
Purpose for Refinance: Cash out?______Lower Rate?______
Current Mortgage Company name and phone number ______
Would you like closing costs added into your loan if possible?______
Homeowner’s Insurance Company and agent______
Insurance Agent’s Phone Number______
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Who can we thank for your referral?______
What is your email address?______
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I/We hereby authorize North American Savings Bank to order a preliminary credit report.
______
Signature Signature Date
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Please return this completed application to:
North American Savings Bank
Attn: “The Alderman Team”
789 NE Rice Road
Lee’s Summit, Mo.64086
Or FAX back to us at (816) 347-4215. Once we have reviewed the enclosed information, we will contact you to set an appointment for your formal loan application.
Thank you for your cooperation and if you have any questions, please don’t hesitate to contact us at (816) 347-4240.
Jim Alderman- Loan Officer- 347-4240
Kyle Sinclair- Loan Officer- 347-4295
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