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State:                      Please Select: Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Caroliina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washinton West Virginia Wisconsin Wyoming

Co-Applicant?:         Please Select: Yes No

Interested in:           Please Select: Single Family Residence Modular Manufactured-on-Land Manufactured-in-Park Condo/Townhome Construction Land Refinance Rehab Commercial Aquisition & Development

Purchase $/Value: $   (Min. $20,000)

Down Pmt:            $   

Rate Your Credit:         Please Select: 5- Really Good 4- Pretty Decent 3- Problems 2- Yikes!

Gross Mo. Income:    $

Mo. Consumer Debt: $

Modular/Manufactured Home Info: 

Yr Manufactured:         Please Select: 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960

                         Anything else?