Southern Energy – Mobile Homes Factory Direct

Personal Information
Name*
First Name Last Name
Middle Initial*
Phone*
Email*
Date of Birth
MM slash DD slash YYYY
SSN*
Address*
Street Address Address Line 2 City State ZIP Code

Employment Information
Employer*
Length of Employment*
Monthly Employment Income*
Other Source of Income (retirement SSI, 2nd job), Amount*

Additional Information
Land*
- Own Land
- Need Land
Type of Loan Requested?*
Do you have a co-applicant?*
- Yes
- No

Co-Applicant Information
Name*
First Name Last Name
Middle Initial*
Phone*
Email*
Date of Birth
MM slash DD slash YYYY
SSN*
Employer*
Length of Employment*
Monthly Employment Income*

Consumer Credit Authorization*
CONSUMER CREDIT REPORT AUTHORIZATION In connection with shopping for a manufactured home and mortgage loan, the undersigned acknowledge that they have asked MOBILE HOMES FACTORY DIRECT for a pre-qualification which requires MOBILE HOMES FACTORY DIRECT to first obtain a consumer credit report. The undersigned hereby knowingly consent to the use of such credit reports consistent with the Federal Fair Credit Reporting Act as contained in U.S.C. @ 1681 et seq. The undersigned acknowledge and certify that MANUFACTURED HOUSING CONSULTANTS has a legitimate business need for the credit report(s) for a permissible purpose and acknowledge that the undersigned have initiated this request. The undersigned further acknowledge that MOBILE HOMES FACTORY DIRECT is authorized to furnish their credit reports per the TEXAS AND FEDERAL CREDIT REPORTING LAWS to potential mortgage lenders. The undersigned agree to waive, release, and hold harmless MOBILE HOMES FACTORY DIRECT from and against any and all claims and causes of action involving the furnishing of my credit report in reliance on the authorization. The undersigned agree to indemnify MOBILE HOMES FACTORY DIRECT for any and all fees, costs, and expenses, including reasonable attorney fees arising in connection with any claim or cause of action brought in connection with MOBILE HOMES FACTORY DIRECT furnishing of my credit report in reliance of this authorizations. The undersigned understand(s) that this Authorization neither commits them to obtaining a mortgage nor is it a commitment to provide a mortgage loan to the undersigned.
- I Agree
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