Online Loan Application By submitting below, you are requesting Sexton to submit your information to two top local Cincinnati lenders for loan consideration. Your information below is strictly confidential and will not be used by any outside parties other than Roger Sexton and his preferred two lenders. Your credit information will not be run without your written authorization! Your loan approval will take place within 24 hours, subject to credit approval and terms of local institution(s).
BORROWER
Borrower (Full Name)
Date of Birth (ex. dd/mm/yyyy)
Soc. Security #
Residence Phone #
Business Phone #
Present Address	Street: City: State:    Zip:
E-mail Address
Years at Present Address
Do you currently	Rent Own
Monthly Mortgage/Rent Payment
Previous Address	Street: City: State:    Zip:
Marital Status	Married Seperated Unmarried (single divorced or widowed)
Occupation (Position & Title)
No. # of Years
Place of Employment (Name & Address)
Previous Employer
CO-BORROWER
Co-Borrower (Full Name)
Date of Birth (ex. dd/mm/yyyy)
Soc. Security #
Residence Phone #
Business Phone #
Co-Borrower's Address (If same, indicate same)
E-mail Address
Years at Present Address:
Do you currently	Rent Own
Monthly Mortgage/Rent Payment
Previous Address (If same, indicate same)
Marital Status	Married Seperated Unmarried (single divorced or widowed)
Occupation (Position & Title)
No. # of Years
Place of Employment (Name & Address)
BORROWER INCOME INFORMATION
Borrower Self-Employed	Yes No
Base Salary $
Overtime $
Bonuses $
Commissions $
Dividends $
Net Rental Income $
Other, please specify amount and source
Total $
CO-BORROWER INCOME INFORMATION (IF APPLICABLE)
Co-Borrower Self-Employed	Yes No
Base Salary $
Overtime $
Bonuses $
Commissions $
Dividends $
Net Rental Income $
Other, please specify amount and source
Total $
COMBINED ASSETS
Checking $
Name of Bank for Checking Account
Savings $
Bank for Savings Account
Credit Union $
Name of Credit Union
Stocks $
Bonds $
Life Insurance $
Present Residence (If owned:)
Market Value
Estimated Mortgage Amount Due
Lender of Your Current Mortgage
Other Assets, (Please Specify)
Liabilities (Include all other loans both personal and lines of credit)
Creditor #1
Type / Creditor Name
Unpaid Balance $ / Due Date
Monthly Payment $
Creditor #2
Type / Creditor Name
Unpaid Balance $ / Due Date
Monthly Payment $
Creditor #3
Type / Creditor Name
Unpaid Balance $ / Due Date
Monthly Payment $
Creditor #4
Type / Creditor Name
Unpaid Balance $ / Due Date
Monthly Payment $
Creditor #5
Type / Creditor Name
Unpaid Balance $ / Due Date
Monthly Payment $
Additional creditor information, please be specific and provide the same information as previously listed for each creditor here
Do You Intend To Occupy This Property ?	Yes No
Other Obligations
Number of Children
Ages
Alimony $
Child Support $
Other Dependents $
Child Care $
Are There Any Judgements or Lawsuits Present	Yes No
Is any part of the down payment or settlement costs being obtained from a source other than from assets listed above	Yes No
I hereby give my consent to have my credit report secured from any credit reporting agency which you designate.	Yes No Please contact me first by telephone