Gelt Financial Corp.
2755 Philmont Avenue, Suite 130, Huntingdon Valley, PA 19006        Phone: 215-357-4955        Fax: 215-357-7250
 
Referred by:  
 
 LOAN INFORMATION
 
Borrowers: Individual/Sole Proprietor  Corporation  partnership
Loan Amount Desired:  $ (min. 50,000 - round to nearest dollar)
Purpose of Loan: Purchase Refinance:
 
 PROPERTY INFORMATION
 
Subject Property Address:   
City:    *
State:     *
ZipCode:    *
Owner Occupied: yes No
Property Description:   
Number Of Units:   Residential:   Commercial: 
Date Purchased:   
Purchase Price:   
Present Value: $
Present Mtg.: $
Title to be held: Individual Corporation Partnership
Proposed LTV:    %
Title to be held in name of:   
Tax Id: #   
Repair Cost (if applicable):   
After Repaired Value (ARV):   
Rent received:   
Proposed Rent:   
 
 APPLICANT/GUARANTOR INFORMATION
 
Borrower (if individual) or Guarantor (if Corporation or Partnership):
 
SS #:   
Name:   
Age :   
Home Phone:    *
Present Address:   
City:    *
State:    *
ZipCode:    *
Property: Own Rent                     No Of Years:  
Marital Status: Married Unmarried Seperated
No. of Dependants:   
Date Purchased:   
Purchase Price: $
Present Value: $
Present Mtg.: $
Mobile Phone #:    
Fax # :   
Email Address:    *
Name and Address of Employer:       No. of Years:  
Self Employed:  Yes No
Position/Title:   
Years in Profession:   
Business Phone:    
 
 CO-APPLICANT/CO-GUARANTOR INFORMATION
 
Co-Borrower (if individual) or Co-Guarantor (if Corporation or Partnership)
 
SS #:   
Name:   
Age :   
Home Phone:    
Present Address:   
City:   
State:   
ZipCode:   
Property: Own Rent                    No Of Years:  
Marital Status: Married Unmarried Seperated
No. of Dependants:   
Date Purchased:   
Purchase Price: $
Present Value: $
Present Mtg.: $
Mobile Phone #:    
Fax # :   
Email Address:   
Name and Address of Employer:     No. of Years:  
Self Employed:   Yes No
Position/Title:   
Years in Profession:   
Business Phone    
 
 INCOME
       
Monthly income
    Borrower   Co-Borrower   Total
Emp. Income $ $ $
Rental Income $ $ $
Div/Int $ $ $
Other(Specify)
$ $ $
$ $ $
Total Income $ $ $
 
 OTHER INFORMATION
 
   Borrower  Co-borrower
Have you any outstanding judgement? YesNo YesNo
Are you obligated to pay child support? YesNo YesNo
Have you declared bankruptcy in the last seven years? YesNo YesNo
Are you a party in a law suit? YesNo YesNo
Are you a U.S. Citizen? YesNo YesNo
Are you a permanent resident alien? YesNo YesNo
*Payments past due 30 days including forbearance aging? YesNo YesNo
Is any part of the down payment borrowed ? YesNo YesNo
*Foreclosed/deed in lieu action taken? YesNo YesNo
BORROWER/COBORROWER INITIALS  
 
 ASSETS AND LIABILITIES
 
Schedule of Real Estate Owned
 
  Property Address   Title in name of   Property Type   Date Purchased   Present Value   Mortgage  Rent  PITI  Net
$ $ $ $ $
$ $ $ $ $
$ $ $ $ $
$ $ $ $ $
$ $ $ $ $
$ $ $ $ $
$ $ $ $ $
$ $ $ $ $
$ $ $ $ $
 
Assets   Liabilities  
 
Cash: $ Revolving Account(s): $
Marketable Securities: $ Auto Loan(s): $
Market Value of Real Estate: $ Mortgage : $
Vested Interest in Retirement Fund: $ note(s): $
Total Asset $ Total Liabilities: $
Net Worth: $
 
 ACKNOWLEDGEMENT AND AGREEMENT
 
I authorize Lender to make inquiries necessary to verify the accuracy of the statements mad e and to determine my creditworthiness. I certify that the above and the statements contained in the attachments are true and accurate as of the stated date(s). These Statements are made for the purpose of either obtaining a loan or guaranteeing a loan.
 
 
Borrower/Guarantor Signature:            Date:           Co-borrower/Co-guarantor Signature            Date:
 
 INFORMATION FOR GOVERNMENT MONITORING PURPOSES
 
The following information is requested by the Federal Government for certain types of loans relating to a dwelling in order to monitor the Lender’s compliance with equal credit opportunity, fair housing and home mortgage disclosure laws. You are not required to furnish this information, but are encouraged to do so. The law provides that the lender may neither discriminate on the basis of this information, nor on weather you choose to furnish it. However, if you choose not to furnish it, under Federal Regulations, this Lender is required to note race or sex on the basis of visual or surname. If you do not wish to furnish the above information, please check the box below. Lender must review the above material to assure that the disclosures satisfy all requirements to which the Lender is subject under applicable state law for the particular type of loan applied for.
 
 
Borrower/Guarantor Co-borrower/Co-guarantor
 
I do not wish to furnish this information I do not wish to furnish this information
Race/National Origin American Indian or Alaska Native Race/National Origin American Indian or Alaska
  Asian or Pacific Islander   Asian or Pacific Islander
  Black, not of Hispanic Origin   Black, not of Hispanic Origin
  White, not of Hispanic Origin   White, not of Hispanic Origin
  Other   specify:    Other   specify: 
Sex Male  Female Sex Male  Female
 
* Required fields