Loan Application Borrower* First Last Phone*Email* DOB MM slash DD slash YYYY SSN Co-Borrower First Last PhoneEmail DOB MM slash DD slash YYYY SSN Current Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Previous Address (if less than 2 years at current address) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Current Employer Employer PhonePrevious Employer (if less than 2 years at current job) Previous Employer PhoneLoan Type* Purchase Construction Refinance