Top Notch Homes Buying a New Home? Let's Get Started! Complete in Minutes - Fast, Easy, No Account Sign-Up & Fully Secure Step 1 of 10 10% Home DetailsHow Will Property be Used?*Select OnePrimarySecondaryWhat Type of Home is Being Purchased / Built?*Select OneManufacturedModularBarndominiumWhat Type Manufactured Home Purchase?*Select OneHome Only - Chattel LoanLand in Lieu - Home & Land Owned Free and ClearLand Home Combo - Home & Land w PayoffOne Time Close - FHA, VA, USDA, HUD 184Where Will the Home Set?*Select OneManufactured ParkPersonal LandFamily LandPark Name and Monthly Rent* What is the Estimated Construction Cost of Home?What Type of Mortgage Loan Needed? (If Known)*Select OneFHAVAUSDANative AmericanNot sure, Compare OptionsLand DetailsDo You Own the Land?*Select OneYes (Titled in Your Name)No (Will Be Purchasing)Family Land (Land Titled in Others Name)Estimated Value / Purchase PriceAmount Owed on the Land? (If Applicable)What State will the Property Be Located?*Select OneAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificLoan NotesProvide Details of Transaction* Borrower DetailsName* First Last Current Address:* Street Address City State / Province / Region ZIP / Postal Code Do You Pay Rent?*Select OneYesNoWhat is the Amount of Rent? Name of Landlord? Phone Number?* How Long Have You Lived at Current Address?*Select One1 YR2 YRs3 YRs +Additional Addresses (Please List 3 yrs)*Please Provide a Full 3yr of Residences, including management company or landlord information.Phone*Email Date of Birth*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920SSN* Social Security # is required to obtain a credit report and provide the loan pre-approval. If you do not want to provide your Social Security # online, a loan officer will contact you to obtain and go over your mortgage options.Estimated Credit Score*Select OneExcellent (720+)Good (680-719)Average (620-679)Fair (580-619)Poor (<580)Not SureAre you a Veteran?*Select OneYesNoAre you a Native American?*Select OneYesNoWhat Tribe Are You a Member of?* Borrower Income/ AssetsIncome Type*Select OneW-2 EmployeeSelf EmployedRetired / DisabilityEmployer / Company* Time at Current Employer*Select One1 YR2 YRs3 YRs +Additional Employers (Please List 3 Yrs)*Please Provide a Full 3yr of Employment History, including dates and contact information.Monthly Income Amount(W-2: Base, OT, Bonus, Commission) (Self Employed: Net After Expenses) ( Retirement: Pension, SSI, Disability)Additional Details: Include (W-2: Base, OT, Bonus, Commission) (Self Employed: Net After Expenses) ( Retirement: Pension, SSI, Disability)(Provide Any Relevant Details)Assets - Checking(Checking Accounts)Assets - Savings(Savings Accounts)Assets - IRA, 401K, Mutual Funds, Etc(Liquidable Retirement Accounts) Borrower DebtsDo You Pay Alimony / Child Support Amount?*Select OneYesNoAlimony / Child Support Amount Breakout - (Amount, Number of Children, Ages)* Do You Currently Own a Home?*Select OneYesNoHave You had a Bankruptcy or Foreclosure in the Last 7 Years?*Select OneYesNo Spouse or CoBorrowerAre You Married?*Select OneYesNo“Primary Residence” requires spouse information on all FHA, VA, USDA, HUD 184 Loans in Community Property States – AZ, CA, ID, LA, NV, NM, TX, WA, WI? - Please select Yes for co-borrower if applicable.Is Your Spouse Going to be or Do You Have a Coborrower?*Select OneYesNo Spouse/Co-Borrower InformationName* First Last Different Home Address?*Select OneYesNoAddress* Street Address City State / Province / Region ZIP / Postal Code Do You Pay Rent?*Select OneYesNoWhat is the Amount of Rent? Name of Landlord? Phone Number?* How Long Have You Lived at Current Address?*Select One1 YR2 YRs3 YRs +Additional Addresses (Please List 3Yrs)*Please Provide a Full 3yr of Residences, including management company or landlord information.Phone*Email Date of Birth*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920SSN* Social Security # is required to obtain a credit report and provide the loan pre-approval. If you do not want to provide your Social Security # online, a loan officer will contact you to obtain and go over your mortgage options.Estimated Credit Score*Select OneExcellent (720+)Good (680-719)Average (620-679)Fair (580-619)Poor (<580)Not SureAre You a Veteran?*Select OneYesNoAre You a Native American?*Select OneYesNoWhat Tribe Are you a Member of?* Spouse/Co-Borrower Income / AssetsIncome Type*Select OneW-2 EmployeeSelf EmployedRetired / DisabilityEmployer / Company* Time at Current Employer*Select One1 YR2 YRs3 YRs +Additional Employers (Please List 3 Yrs)*Please Provide a Full 3yr of Employment History, including dates and contact information.Monthly Income Amount(W-2: Base, OT, Bonus, Commission) (Self Employed: Net After Expenses) ( Retirement: Pension, SSI, Disability)Additional Details: Include (W-2: Base, OT, Bonus, Commission) (Self Employed: Net After Expenses) ( Retirement: Pension, SSI, Disability)(Provide Any Relevant Details)Assets - Checking(Checking Accounts)Assets - Savings(Savings Accounts)Assets - IRA, 401K, Mutual Funds, Etc(Liquidable Retirement Accounts) Spouse/Co-Borrower DebtsDo You Pay Alimony / Child Support Amount?*Select OneYesNoAlimony / Child Support Amount Breakout - (Amount, Number of Children, Ages)* Do You Currently Own a Home?*Select OneYesNoHave you had a Bankruptcy or Foreclosure in the Last 7 Years?*Select OneYesNo Dealer / Builder InformationHiddenClient Relationship Manager HiddenDealer/Builder Name HiddenDealer/Builder Location (City) HiddenDealer/Builder Salesperson*Select One Authorization / SubmissionCredit Authorization*Select OneYesNoSpouse or Coborrower Credit Authorization*Select OneYesNoRelease Consent* Authorization to Share InformationI authorize information about my loan application to be shared with the manufactured home dealer, including but not limited to: pre-approval, credit score, debt to income and assets available for the purchase.Contact Consent* I Agree to be ContactedCapital Home Mortgage uses multiple systems to efficiently communicate important information to our customers. By clicking "SUBMIT" below, you are also providing express written consent to contact you, using the information you provided above and/or the information you provide in your initial application, which may also be noted above, including phone (land, mobile, or VoIP), email address, and/or mailing address, to include contacting you through automated means, such as 1) autodialing, text, and pre-recorded messaging via telephone, 2) mobile device, including SMS and MMS, and/or 3) email, even if you are on a corporate, state, or national Do Not Call Registry. Δ