Coastal Financial

Purchase Application (U.S.V.I.)

Our quick and easy application simplifies the process of submitting your qualifying information. To ensure your privacy and data security, all data transmissions are sent using secure servers and lines.

Whether your credit is "Outstanding" or "Less Than Perfect," loan approval is quick and easy at Coastal Financial Company (LLC).

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*DENOTES A REQUIRED FIELD

DATE:*
NAME(S):*
PHYSICAL ADDRESS: *
HOW LONG?: *
MAILING ADDRESS: *
Phone #:* Phone #:
E-Mail Address:*

BORROWER

NAME:*
ADDRESS: *
SOCIAL SECURITY NUMBER: * DATE OF BIRTH: *
Name of your employer: *
Address: *
What is your Job Title?: *
How long have you worked there?: *
How much do you receive weekly?: *
ANY OTHER INCOME: *
Are you: * # of Dependents: * Ages:

CO-BORROWER

NAME:
ADDRESS:
SOCIAL SECURITY NUMBER: DOB:
Name of your employer:
Address:
What is your Job Title?:
How long have you worked there?:
How much do you receive weekly?:
ANY OTHER INCOME:
Are you: # of Dependents: Ages:
E-Mail Address:

What is the ADDRESS of the property?: *
PURCHASE PRICE?:* PUTTING DOWN?: *
IS THIS YOUR PRIMARY RESIDENCE or SECOND HOME?: *
IS THIS A CONDO, SINGLE-FAMILY or MULTI-FAMILY?: * If multi, how many units?
REALTOR'S NAME : REALTOR'S PHONE #:

CREDIT

MORTGAGE/RENT
Property Address: * Value:
Bank: Monthly Payment: Balance:
CAR LOAN
Bank: Monthly Payment: Balance:
CREDIT CARDS
Bank: Monthly Payment: Balance:
CREDIT CARDS
Bank: Monthly Payment: Balance:
CREDIT CARDS
Bank: Monthly Payment: Balance:

ASSETS

SAVINGS:
Bank: * Balance:*
Bank: Balance:

CHECKING:
Bank: * Balance:*

© Coastal Financial Company "LLC"
Mortgage Banker ● Broker ● Portfolio Lender
Main Office: 199 Main St Suite#16 ● East Haven, CT 06512
Toll Free Nationwide 1-800-701-4021
Tel. 203-468-9998 ● Fax 203-469-3194
Email: Coastal.Financial@snet.net ● Website: www.coastalfinancialco.com
Regional Office: P.O. Box 8335 Cruz Bay St. John U.S.V.I. 00831

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