What is your customer's employment status?
Select an Option
Unemployed
Employed
Self Employed
Retired
If employed, what is the name of your customer’s employer?
What is your customer’s
gross base monthly income
from all jobs?
(explain)
$
Does your customer have other sources of income?
(explain)
Yes
No
(You should advise your customer that they do not need to indicate alimony, child support, or separate maintenance income if they do not want to have it considered when we evaluate their ability to repay the loan.)
If your customer is obligated to pay alimony or child support, please enter the amount paid monthly.
$
