117 Neshaminy Road
P.O. Box 330
Croydon, PA 19021
1-800-523-5686

NMLS # 129460

Manufactured Home Credit Application

Or download the PDF version, complete and return to us by FAX 215-781-3715 or 215-781-3716;
or MAIL 117 Neshaminy Road, P.O. Box 330, Croydon, PA 19021

* = Required

APPLICANT INFORMATION

Title:

*Last Name:

*First Name:

*MI:

*Social Security No:

*No. of Dependents:

*Date of Birth:

*Year:

*E-mail:

Present Street Address

*Street Address:

*City:

*State:

*Zip:

*Years There:

*Phone:

Former Street Address

Street Address:

City:

State:

Zip:

Years There:

*Are You a U.S. Citizen? Yes No

If no, describe immigration status:

Marital Status:

Do not select if this application is for individual unsecured credit.

YOUR JOB

*Present Employer:

*Position:

*Years There:

*Wages:

*How Often Are You Paid:

*Street Address:

*City:

*State:

*Zip:

*Business Phone:

Badge No:

Former Employer (if less than 3 years)

Former Employer:

Position:

Years There:

Street Address:

City:

State:

Zip:

Business Phone:

OPTIONAL INCOME

Alimony or child support or separate maintenance payments are optional information and need not be revealed if the applicant does not choose to rely on such income in applying for credit.

Source:

ADDITIONAL INCOME

Investment Income $

Source:

FINANCIAL

Checking - Bank

Balance $

Branch

Savings - Bank

Balance $

Branch

CREDITOR INFORMATION

Debts - List all banks, stores, loan & finance companies, credit unions and others to whom you are indebted. Include any revolving line of credit.

Creditors

		Monthly Payment	Present Balance
Landlord or Mortgage Holder *
1
Auto - Lienholder
2
	Year Make
3
4
5
6
7
8
9
10
11
12

Other Obligations

No. of Dependents and Ages

Total Monthly Liability to pay alimony, child support or separate maintenance $

Credit References

Previous Credit

I have received credit in the past while using the following name

Name:

Creditor:

Year:

*Are You a Co-maker, Endorser or Guarantor on Any Loan or Contract? Yes
No

If "yes" for whom?

To whom?

*Are There Any Unsatisfied Judgments Against You? Yes No

Amount: $

If Yes, To Whom Owed?
Omit if More Than 7 years

*Were You Ever Bankrupt? Yes No

If “Yes” Where:

Year:
Omit if More Than 10 years

Name of Nearest Relative or Friend Not Living With You:
* First:
*Last:

*Street Address:

*City:

*State:

*Zip:

*Phone:

Description of property securing credit (if applicable)

CO-APPLICANT INFORMATION

Title:

*Last Name:

*First Name:

*MI:

*Social Security No:

*No. of Dependents:

*Date of Birth:

*Year:

*E-mail:

Co-Applicant Present Street Address

*Street Address:

*City:

*State:

*Zip:

*Years There:

*Phone:

Former Street Address

Street Address:

City:

State:

Zip:

Years There:

*Are You a U.S. Citizen? Yes No

If no, describe immigration status:

Marital Status:

Do not select if this application is for individual unsecured credit.

YOUR JOB

*Present Employer:

*Position:

*Years There:

*Wages:

*How Often Are You Paid:

*Street Address:

*City:

*State:

*Zip:

*Business Phone:

Badge No:

Former Employer (if less than 3 years)

Former Employer:

Position:

Years There:

Street Address:

City:

State:

Zip:

Business Phone:

CO-APPLICANT'S OPTIONAL INCOME

Alimony or child support or separate maintenance payments are optional information and need not be revealed if the applicant does not choose to rely on such income in applying for credit.

Source:

CO-APPLICANT'S ADDITIONAL INCOME

Investment Income $

Source:

CO-APPLICANT'S FINANCIAL

Checking - Bank

Balance $

Branch

Savings - Bank

Balance $

Branch

CREDITOR INFORMATION

Debts - List all banks, stores, loan & finance companies, credit unions and others to whom you are indebted. Include any revolving line of credit.

Creditors

		Monthly Payment	Present Balance
Landlord or Mortgage Holder *
1
Auto - Lienholder
2
	Year Make
3
4
5
6
7
8
9
10
11
12

Co-Applicant Other Obligations

No. of Dependents and Ages

Total Monthly Liability to pay alimony, child support or separate maintenance $

Co-Applicant Credit References

Previous Credit

I have received credit in the past while using the following name

Name:

Creditor:

Year:

*Are You a Co-maker, Endorser or Guarantor on Any Loan or Contract? Yes No

If "yes" for whom?

To whom?

*Are There Any Unsatisfied Judgments Against You? Yes No

Amount: $

If Yes, To Whom Owed?
Omit if More Than 7 years

*Were You Ever Bankrupt? Yes
No

If “Yes” Where:

Year:
Omit if More Than 10 years

CREDIT INQUIRIES

I/WE AUTHORIZE the Lender to make whatever credit inquiries it deems necessary in connection with the credit application or in the course of review or collection of any credit extended in reliance on the application. I/We authorize and instruct any person or consumer reporting agency to compile and furnish to the Lender any information it may have or obtain in response to such credit inquiries and agree the same shall remain your property whether or not credit is extended.
I am/We are hereby notified that a consumer report may be requested in connection with this credit application. If I/we request, I/we will be informed whether or not a consumer report was requested, and if such report was requested, I/we will be informed of the name and address of the consumer reporting agency that furnished the report. Subsequent consumer reports may be requested or utilized in connection with an update, renewal or extension pf the credit.
All information set forth in this application is declared to be a true representation of facts for the purpose of obtaining the credit requested and any willful misrepresentation on this application could result in criminal action.
NOTICE TO GUARANTOR: If you are providing information to the Lender on this Application for the purpose of acting as a guarantor for one or more primary applicant(s) and the Lender determines that you, as a guarantor, do not meet the credit underwriting standards for this particular loan and/or amount, be advised that the Lender is required by law to, and will, provide an adverse action notice detailing the specific reasons for the credit denial directly to the primary applicant(s) and not to you.
As a guarantor, be prepared to share any specific reasons for adverse actions based on your credit history with the primary applicant(s). If you are unwilling to share this information, you should not complete this application in the capacity of the guarantor.
By completing and submitting this application as guarantor, you are authorizing the Lender to share the specific reasons for adverse action with the primary applicant(s) in the event this application is denied.

IMPORTANT INFORMATION ABOUT PROCEDURES FOR OPENING A NEW ACCOUNT:
To help the government fight the funding of terrorism and money laundering activities, Federal Law requires all financial institutions to obatin, and record information that identifies each person who opens an account.
What this means for you: When you open an account, we will ask for your name, address, date of birth, and other information that will allow us to identify you. We will also ask to see your driver's license or other identifying docuemnts and make copies.

IMPORTANT: THIS APPLICATION MUST BE SIGNED AND DATED BELOW, BEFORE IT CAN BE PROCESSED.
By typing the applicant name(s) into the boxes, you are effectively signing this application electronically.

*Signature Of Applicant
*Date

Signature Of Co-Applicant
Date

Information For Government Monitoring Purposes
The following information is requested by the Federal Government for certain types of loans related to a dwelling, in order to monitor the Lender's compliance with equal credit opportunity, fair housing and home mortgages disclosure laws. You are not required to furnish this information, but are encouraged to do so. The law provides that a lender may neither discriminate on the basis of this information, nor on whether you choose to furnish it. If you furnish the information, please provide both ethnicity and race. For race, you may check more than one designation. If you choose not to furnish it, under Federal regulations this lender is required to note race and sex on the basis of visual observation or surname. If you do not wish to furnish the following information, please check the box below. (Lender must review the above material to assure that the disclosures satisfy all requirements to which the Lender is subject under applicable state law for the particular type of loan applied for.)

Applicant

I Do Not Wish To Furnish This Information
Ethnicity:
Race:
Gender:

Co-Applicant

I Do Not Wish To Furnish This Information
Ethnicity:
Race:
Gender: