Quick Application

    fax application to 781-663-6755

    email application to eva.kokosinska@nemoves.com

Name _____________________________________________________________________________

Address_____________________________________________________________________________

City____________________________________________State____________ ZIP_________________

Social Security # _______________________________   Date of Birth_________________________

(H) Phone ________________________________  (W) Phone ________________________________

Email: _________________________________________________

Income :______________ Per hr/salary  Social Security? ___________________
Child Support/Alimony? _______________     Pension? ____________________
Do you receive: overtime?_____ bonuses?_____ shift differential?_____ commission?______
Are you self employed? ___________
If yes to any of these questions, what was your start date at job? ___________

What is an approximate value of your assets?
Checking/Savings? _______________________  CD? _________________________________

401k/401b/ISOP? ________________________  Pension Plan? ________________________
Stocks/Bonds? __________________________  Equity in home? _________________________
Gifts funds to be received? _________________  Other expected assests? __________________

Co-Borrower

Name ____________________________________________________________________

Address_____________________________________________________________________________

City____________________________________________ State___________ ZIP_________________

Social Security # _______________________________   Date of Birth ________________________

(H) Phone ________________________________  (W) Phone ________________________________

Email: _________________________________________________

Income :______________ Per hr/salary  Social Security? ___________________
Child Support/Alimony? _______________     Pension? ____________________
Do you receive: overtime?_____ bonuses?_____ shift differential?_____ commission?______
Are you self employed? ___________
If yes to any of these questions, what was your start date at job? ___________

What is an approximate value of your assets?
Checking/Savings? _______________________  CD? _________________________________

401k/401b/ISOP? ________________________  Pension Plan? ________________________
Stocks/Bonds? __________________________  Equity in home? _________________________
Gifts funds to be received? _________________  Other expected assests? __________________

Are you interested in buying / refinancing :

Single Family? Condo? Multi-family (2-4) units?
Investment property?

Please indicate best time to contact you, best manner of contact (telephone, email)

**If more than one borrower, please indicate best person to contact.