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COMPLETE FOR RENTAL REHAB REQUESTS FOR OVER $10,000 <br />INCOME AND ASSETS <br />(over $10,000 requests) <br />Applicant's Employer (Name, Address): Phone No.: Position: Yrs.: Income <br />Earned: <br />$ <br />Co-Applicant or Guarantor 's Employer (Name, Address): Phone No.: Position: Yrs.: Income <br />Earned: <br />$ <br />Other Sources of Income Income <br />Earned: <br />$ <br />Total Annual Income from sources indicated above: $ <br />Note: You must provide a copy of your personal financial statements. If you do not have them prepared, ask your lender <br />for a blank copy to complete. <br />CREDIT INFORMATION <br />(over $10,000 request) <br />Are there any outstanding judgments or liens against you? No Yes <br />Have you declared bankruptcy within the last 36 months? No Yes <br />Have you had any property foreclosed upon or given title or deed in lieu thereof? No Yes <br />Are you a co-maker or endorser on a note? No Yes <br />List all current fixed obligations, installment accounts, charge accounts, loans, and debt to banks, finance companies and <br />Government agencies. <br />Type of Debt Current Balance: Monthly Payment: <br />Total Personal Installment Debt $ $ <br />Total Personal Revolving Debt $ $ <br />Real estate debt for property other than improved $ $ <br />Total Business Debt $ $ <br />4 <br /> <br />