Borrower Name
Co Borrower Name
Current Address
Current Address
City, State, Zip
City, State Zip
Daytime Phone
Email Address
Loan Amount $
Lot Cost $
Lot Size
Date of Purchase
Lot Current Value (if applicable) $
Balance Owed on Lot $
Sq ft of Home to be Built
Garage
Yes
No
Basement:
Yes
No
Cost to Build (materials & labor only) $
Estimated Time to Build (months)
Building Permits Approved
Yes
No
Construction Started
Yes
No
If "Yes" Percent Completed %
Estimated Completed Value $
(For Office Use Only: LTV________)
Cash Available to Invest in Property $
Source of Cash
Savings
Sale of Home
Gift
Other
Total Savings 401k, IRA's, Stocks, Etc $
Is Your Credit Score (choose one)
Excellent
Good
Fair
Poor
If you know your credit score?
Borrower Monthly Salary $
Do you receive a W2
Yes
No
Co-Borrower Monthly Salary $
Do you receive a W2
Yes
No
Borrower Employer
Co-Borrower Employer
Borrower Length of Employment (years)
Co Borrower Lenght of Employment (years)
Construction Type (choose one)
Stick Built
Modular
Log Home
Timber Built
Other
Have You Chosen a Builder?
Yes
No
If Yes, how did you choose this builder?
Does the Builder have good credit?
Yes
No
Not Sure
How many homes has the Builder built in the past three years?
NOTE : ** If Builder is to Complete Less Than 90% of Project, Please Submit Under the Self Build
Fax to (585) 256-2836 or E-Mail to info@normandy.com