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Purchase Agreement Information

Sellers Name:

Phone Number:

* Selling Price:

* Down Payment:

* Source of Down:

* Current Home:

Home Information

* Manufacturer:

Model name:

* Year:

* Width/Length:

* Manufactured Home Physical Address:

* City:

* St:

* Zip:

Home Location

Park/Community Name:

Monthly Lot Rent:

Applicant Information

* First Name:

Middle Name:

* Last Name:

Suffix:

* Date of Birth:

* Soc. Sec. No:

* Rate Credit:

* Bankruptcy:

* Major Credit Card:

Yes

* Home Phone:

Cell Phone No:

* Email Address:

* Contact Method:

* Current Mailing Address:

* City:

* St:

* Zip Code:

* How Long:

Previous Address:

Years at Prev. Add.

Employment/Income Information

Employer Name:

City and State:

Work Phone:

* Monthly Salary:

Years at job:

Years in Field:

Position/Title:

Supervisor:

Prev. Employer:

Position/Title:

Length at Prev. Emp.

Addt'l income:

Source:

Income Verifiable:

Yes

Child Support:

Yes

Co-Applicant Information

Co-App First Name:

Co-App Middle Name:

Co-App Last Name:

Suffix:

Date of Birth:

Soc. Sec. No:

Rate Credit:

Bankruptcy:

Major Credit Card:

Yes

Home Phone:

Co-App Cell #:

Co-App Email:

Contact Method:

Co-App Current Address:

Years at address:

Co-App Previous Address:

Yrs at Prev. Add:

Co-Applicant Employment/Income Information

Employer Name:

City and State:

Work Phone:

Monthly Salary:

Years at Job:

Years in Field:

Position/Title:

Supervisor:

Previous Employer:

Position/Title:

Length at Prev. Employer:

Addt'l Income:

Source:

Income Verifiable:

Yes

Child Support:

Yes

Please Read Prior to Submission

Everything that you have stated on this application is correct to the best of your knowledge and you acknowledge you are of legal age to enter into this transaction. You understand that JCF and/or its affiliates will retain this application whether or not it is approved. JCF and/or its affiliates are authorized to check your credit and employment history and to ask questions about the lender's credit experience with you. You agree to inquire about the status of this application by contacting JCF Lending Group. You understand that this application may be considered withdrawn and/or canceled if you do not inquire about its status within 30 days of the date of application. You may apply for joint credit with a spouse or another person. A married applicant may apply for individual credit.

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