119 Beechnut Lane
Statesville, NC 28625
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2001 sq ft and over
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Please fill out the application form below to apply for a house loan.
Note that by submitting this form, you give 1st Choice Housing and
the bank that we send your application to, permission to do a credit
check.
All the fields are required!
Name
(Including middle initial)
Social Security Number
Enter like this
222-33-4444
Please enter all
NINE
digits
Birth date
Marriage Status
Married
Divorced
Separated
Single
Number of Dependants
(How many children?)
1
2
3
4
5
6
7
8
9
10 or more
What are their ages
(Separate ages with a comma)
Present Street
City
State
Zip
Contact Phone
(Home or other Contact Number)
Cell Phone (Not required)
Fax Number (Not required)
How long (
have you lived at
present )
Do you rent or own?
Rent
Own
Live with family
How much Rent/Month?
Previous
(If less
than 2 years at present )
Current Employer
Employers
Employers Phone #
Hire Date
Job Title
Gross Salary
(How much
do you make before tax)
Pay Period
Per Hour
Per Week
Per Month
Per Year
If paid by the hour,
how
many hours average per week
Do you get Overtime?
No
Yes
Hours
per week
Previous Employer
(If less
than 2 years at present job)
Do you have a
bank account?
Yes
No
Type of
account?
Checking
Savings
Name of Bank
E-mail
(Not required)
If a spouse or another person is going to apply
with you, please enter his/her information below
Name
(Including middle initial)
Social Security Number
Birth date
Current Employer
Employers Phone #
Hire Date
Gross Salary
(How much
do you make before tax)
Pay Period
Per Hour
Per Week
Per Month
Per Year
Additional Comments
Note that by submitting this form, you give 1st Choice Housing and the
bank that we send your application to, permission to do a credit check.
Phone #
704-883-8228
Fax #
704-883-8338
E-mail
info@1stchoicestatesville.com
Address
119 Beechnut Lane
Statesville, NC 28625
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Page last updated March 28, 2008