Loan Application

Date Of Birth

Contact Information

Best Time To Reach You

Total Gross Yearly Income (Income Before Taxes) *

*Self Employed Borrower(s) may be required to provide additional documentation such as tax returns and financial statements.

Notice: Alimony, child support, or separate maintenance income need not be revealed if the Borrower(B) or Co- Borrower(C) does not choose to have it considered for repaying this loan.

Total Monthly Debt Payments (including Alimony & Child Support)

Employment

Additional borrower Information

Will there be a additional borrower on this loan?

Social Security Number

Date Of Birth

How Did You Hear About Us

Loan Information

Credit Check Authorization

Do you authorize us to pull you and your additional borrower’s credit reports in order to pre-qualify you for a loan? (If so, please provide social security numbers and date of births).

 If you have any issues please contact:

Kim Brannon 704-662-2362

EDGEWATER Residential Capital, INC. NMLS# 1577717
344-204B Rolling Hills Rd.
Mooresville, NC 28117

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