Carolina Custom Builders: Application Form

Application Form

Applicant Information/Co-Applicant
(Include information for the applicant and co-applicant)

Applicant:

Birth Date:

Marital Status:

# Dependent Children:

Social Security Number:

Address:

City:

State:

Zip:

County:

Home Phone:

Time at present address:
*(if less then 2 years - please
include previous address)

*Previous Address:

Time at previous address:

Employer's Name:

Gross Salary:

Work Phone:

Employer's City/State:

Hire Date:
*(if less then 2 years at present employer -
please include previous employer)

Previous Employer's Name:

Gross Salary:

Previous Employer's City/State:

Time at Previous Employer:

Co-Applicant:

Birth Date:

Marital Status:

# Dependent Children:

Social Security Number:

Address:

City:

State:

Zip:

County:

Home Phone:

Time at present address:
*(if less then 2 years - please
include previous address)

*Previous Address:

Time at previous address:

Employer's Name:

Gross Salary:

Work Phone:

Employer's City/State:

Hire Date:
*(if less then 2 years at present employer -
please include previous employer)

Previous Employer's Name:

Gross Salary:

Previous Employer's City/State:

Time at Previous Employer:

Property To Be Improved

Date of Purchase:

Purchase Price:

Down Payment:

Balance Owing:

Current Market Value:

Monthly Payment:

Mortgage Holder: 1st

2nd

2nd Monthly Payment:

2nd Mortgage Balance:

Enter the letters displayed in the image above.
If you cannot read the letters, press the Refresh button.

Carolina Custom Builders

4905 Departure Dr
Raleigh, NC 27616
Tel: (919) 790 -1234
Fax: (919) 790 -1010
carolinacustom@hotmail.com
Office Hours: 8 am - 4 pm Monday - Friday

Model Hours: model open to the public - 24 hrs. 7 days a week