Blue Ridge Mobile Homes LLC

Fax back to 434-220-1924 Attn: Sam or email to sam@blueridgemobilehome.com

OWNER FINANCING APPLICATION

APPLICANT 1:

Full Name:____________________________________________________________________
SSN:_______________________ Driver License Number:_____________________________
Phone Number (home)____________________________ (work or cell)__________________
Email address: ________________________________________________________________
Current Residence Address:_____________________________________________________
City/State/Zip:_________________________________________________________________
Landlord Name and Phone Number:______________________________________________
How Long? From:__________ To:___________ Rent amount:________________________
Previous Residence Address:_____________________________________________________
City/State/Zip:_________________________________________________________________
Landlord Name and Phone Number:______________________________________________
How Long? From___________ To ____________ Rent amount:________________________
Current Employment/Company Name:____________________________________________
Address:______________________________________________________________________
City/State/Zip:_________________________________________________________________
Supervisor:________________________________Phone Number:______________________
Position:______________________________________________________________________
How Long? From:____________________________ To:______________________________
Income: _______________________ per____________________________________________
Previous/Other Employment/Company Name:______________________________________
Address:______________________________________________________________________
City/State/Zip:_________________________________________________________________
Supervisor:_________________________________ Phone Number:____________________
Position:______________________________________________________________________
How Long? From:_____________________________ To:_____________________________
Income:_________________________per___________________________________________

Property for which you are applying: _____________________________________________

Downpayment You Can Put Down: $ _____________________________________________

APPLICANT 2:

Full Name:____________________________________________________________________
SSN:_______________________ Driver License Number:_____________________________
Phone Number (home)____________________________ (work or cell)__________________
Email Address: ________________________________________________________________
Current Residence Address:_____________________________________________________
City/State/Zip:_________________________________________________________________
Landlord Name and Phone Number:______________________________________________
How Long? From:_______________________ To:___________________________________
Previous Residence Address:_____________________________________________________
City/State/Zip:_________________________________________________________________

Blue Ridge Mobile Homes LLC

Fax back to 434-220-1924 Attn: Sam or email to Sam@blueridgemobilehome.com
 Blue Ridge Mobile Homes LLC
Fax back to 434-220-1924 Attn: Sam or email to sam@blueridgemobilehome.com
Landlord Name and Phone Number:______________________________________________
How Long? From________________________ To ___________________________________
Current Employment/Company Name:____________________________________________
Address:______________________________________________________________________
City/State/Zip:_________________________________________________________________
Supervisor:________________________________Phone Number:______________________
Position:______________________________________________________________________
How Long? From:____________________________ To:______________________________
Income: _______________________ per____________________________________________
Previous/Other Employment/Company Name:______________________________________
Address:______________________________________________________________________
City/State/Zip:_________________________________________________________________
Supervisor:_________________________________ Phone Number:____________________
Position:______________________________________________________________________
How Long? From:_____________________________ To:_____________________________
Income:_________________________per___________________________________________

ADDITIONAL OCCUPANTS: List name and relationship including age of minor children
_____________________________________ ________________________________________
_____________________________________ ________________________________________

EMERGENCY CONTACT(Name and Phone Number) ______________________________

_____________________________________________________________________________
_

PETS (Description and Approximate Weight):________________________________________

_____________________________________________________________________________
_

Vehicle1: (Year/Make/Model):_____________________License No.______________________

Vehicle 2: (Year/Make/Model):____________________License No.______________________

OTHER INFORMATION: (Explain credit problems on additional page if needed, credit

card / financial information including lien holder, balance owed, monthly payment, etc.)

Has applicant ever been sued for bills?___Ever been locked out of property by sheriff?___
Has applicant ever been bankrupt?______Ever been brought to court by any landlord?___
Applicant ever been guilty of felony?___Ever moved owing rent or damaged apartment?__
Applicant ever broken lease?___Is total move-in amount available now(pymnt & down)?__

SIGNATURES
I/We certify that the information given herein is complete and correct. The Landlord or seller or his agent is hereby
expressly authorized to verify the accuracy and correctness of these statements, to communicate with my/our present
and former employees, creditors and landlords, and to procure such other information (including credit reports)
which the Landlord/Seller may require to evaluate this application.

Blue Ridge Mobile Homes LLC

Fax back to 434-220-1924 Attn: Sam or email to Sam@blueridgemobilehome.com
 Blue Ridge Mobile Homes LLC
Fax back to 434-220-1924 Attn: Sam or email to sam@blueridgemobilehome.com
Signature:_______________________________________________Date:_________________________________

Signature:______________________________________________ Date:_________________________________

Blue Ridge Mobile Homes LLC

Fax back to 434-220-1924 Attn: Sam or email to Sam@blueridgemobilehome.com