Our financing and insurance for manufactured or mobile homes is currently limited to Pennsylvania, New York, New Jersey, Maryland and Delaware. Homes in other states are not eligible for our products and services.

Use this form to send an application to MODERN FINANCIAL PLANS & SERVICES, INC. All application information is treated with promptness and strict confidentiality.

Instructions:

1. Fill out each section of this form to receive a comprehensive evaluation.
2. When you have completed the form click on the "Submit" button at the end of the form.
3. A Modern Financial loan officer will contact you promptly.

Modern Financial Plans & Services, Inc. Manufactured / Mobile Home Financing Application 117 Neshaminy Road, P.O. Box 330 Croydon, PA 19021 Phone (800) 523-5686 Fax (215) 781-3715 or 781-3716
Purpose of Application:
	1. Purchase Mobile / Manufactured Home
	2. Refinance Existing Loan
	3. Home Equity Loan
The Federal Equal Credit Opportunity Act prohibits creditors from discriminating against credit applicants on the basis of sex or marital status. The Federal agency which administers compliance with this law concerning this bank is the Comptroller of the Currency, Consumer Affairs Division, Washington, DC 20210.
Your Name:
Last Name:
First Name:
Middle Initial:
Date of Birth:
Social Security Number:
Present Address:
Street:
City:
State:
Zip Code:
Telephone Number:
E-Mail:
E-mail Address:
Present Employer:
Name of Employer:
Position:
Wages:
Are you wages paid:	Weekly Bi-weekly Monthly
Are your wages:	1. Gross or 2. Net
How many years at job:
Employer Address:
Street:
City:
State:
Zip Code:
Business Phone:
Marital Status:
	1. Married
	2. Separated
	3. Unmarried
Optional Income:
Monthly Amount:
Source:
Landlord or Mortgage Holder:
Do you:	Own or Rent
Who is your landlord/mortgage holder:
Monthly Payment:
Present Balance on Mortgage:
Amount of Child Support Paid:
Amount of child support paid monthly:
Amount of child support receive monthly:
Your monthly debt: (Add up Car Payments, Loan Payments, Alimony, Child Support etc )
Your Credit Profile:
I have had some credit concerns in the past such as:
	1. Repossessions
	2. Liens or Judgments
	3. Bankruptcy
	4. Late Payments due to layoffs or illness
If Co Application, Please Complete Below:
Your Name:
Last Name:
First Name:
Middle Initial:
Date of Birth:
Social Security Number:
Present Address:
Street:
City:
State:
Zip Code:
Telephone Number:
E-Mail:
E-mail Address:
Present Employer:
Name of Employer:
Position:
Wages:
	1. Weekly  2. Bi-Weekly 3. Monthly
Are your wages:	1. Gross or 2. Net
How many years at job:
Business Phone Number:
Description of Home:
Year:
Make:
Length:
Width:
Selling Price:
Down Payment:
Park:
Name of Park:
Lot Rent:
Lot Number:
Park Address:
Street:
City:
State:	Pennsylvania New Jersey New York Maryland Delaware
Zip:
(We are currently limited to PA, NJ, NY, MD, and DE)
Do you intend to occupy this home as your primary residence?	Yes  No
Everything that I have stated in application is correct to the best of my knowledge. I understand that you will retain this application whether or not credit is approved. I am informed that you may request a consumer report (credit report) in connection with this application, and that, if I ask you, you will inform me if such a report is requested and the name and address of the consumer reporting agency that furnished the report. I am also informed that subsequent consumer reports may be requested, or used, in connection with any up-date, renewal or extension of the credit application. I authorize you to obtain such reports and to check my employment history. Information for Government Monitoring Purposes If this loan is related to a dwelling, the following information is requested by the Federal Government in order to monitor the lender's compliance with equal credit opportunity and fair housing 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. However, 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, please initial below.
Borrower:
I do not wish to furnish this information:	(Please initial)
Race/National Origin:
	1. American Indian, Alaskan Native
	2. Asian, Pacific Islander
	3. Black
	4. Hispanic
	5. White
	6. Other, (Please Specify):
Sex:	Male      Female
Co Borrower:
I do not wish to furnish this information:	(Please initial)
Race/National Origin:
	1. American Indian, Alaskan Native
	2. Asian, Pacific Islander
	3. Black
	4. Hispanic
	5. White
	6. Other, (Please Specify):
Sex:	Male      Female