HOME EQUITY APPLICATION

PURCHASE PRICE  $ A value is required.Invalid format.
LOAN AMOUNT REQUESTED  $ A value is required.Invalid format.

 

Applicant
   
Full Name A value is required.
Soc Sec # A value is required.Invalid format.
D.O.B (mm/dd/yyyy) A value is required.Invalid format.
Current Address A value is required.
City A value is required.
State Please select an item.
Zip A value is required.Invalid format.
Cell Phone A value is required.
Home Ph A value is required.
Own Rent
Yrs at Address Please select an item.
Dependents # Please select an item.
Ages
Former Address (if less than 2 yrs. at current)
City
State Please select an item.
Zip Invalid format.
Employer A value is required.
Position A value is required.
Yrs on job Please select an item.
Work phone A value is required.
Self Employed? Yes No
Gross Mo. Income  $ A value is required.Invalid format.
Other Income  $ A value is required.Invalid format.
Former Employer
Position
Email A value is required.Invalid format.
Married Separated Unmarried
   
Co-Applicant
   
Full Name
Soc Sec #
D.O.B (mm/dd/yyyy)
Current Address
City
State
Zip
Cell Phone
Home Ph
Own Rent
Yrs at Address
Dependents #
Ages
Former Address (if less than 2 yrs. at current)
City
State
Zip
Employer
Position
Yrs on job
Work phone
Self Employed? Yes No
Gross Mo. Income  $
Other Income  $
Former Employer
Position
Email
   
Assets
   
Bank Name
Checking Balance  $
Savings Balance  $
Other Assets, 401k etc
   
Authorization  
I/we hereby authorize MED5 Federal Credit Union/Premier Home Mortgage Inc to perform a review and analysis of my/our credit report, to verify my past and present employment, earnings records, bank accounts, stock holdings and any other asset balances that are needed to process this mortgage loan application. It is understood that a copy of this signed form will also serve as authorization. Qualifying information may be discussed with all parties involved in the real estate transaction.
   
Applicant Signature
Co-Applicant Signature


Main Office: 625 Flormann St. Rapid City, SD 57701 | Open Monday-Friday 9:00 a.m. - 5:00 p.m. | (605) 342-7776

Designed and Hosted by The Gage Team. Med5 Federal Credit Union, previously known as Rapid City Medical Federal Credit Union, began serving only members of the medical profession, but has now expanded to serve anyone in the Rapid City community. Med5 has "Benefits that Fit You!"...Savings, Checking, Insurance, Loans and Investments...customized for your individual needs.