SPO Rep.___________________________ Sellers Loan #_________________________________

Buyer’s Real Estate Agent:___________________________________ Real Estate Agent’s Phone/ Email:__________________________________

Property Street Address:___________________________________________________ Number of Units:__________

City:______________________________ County:________________________ State:___________ Zip:____________

Purchase Price:_____________________ Primary Res., Investment Home, 2nd Home (circle on)

BUYER INFORMATION

Buyer:____________________________________________ Co-Buyer:_______________________________________

Age:_______ Date of Birth__________________ Age:________ Date of Birth__________________

Social Security Number___________________________ Social Security Number_______________________

Marital Status: Married Single Divorced Marital Status: Married Single Divorced

Home Phone Number (________)___________________ Home Phone Number(________)________________

Cell Phone Number (_________)____________________ Cell Phone Number(_________)_________________

Work Phone Number(________)____________________ Work Phone Number(________)________________

Present Street Address:__________________________________________ Present Street Address:_______________________________________

City:_____________________ State:______ Zip:_______ City:___________________ State:_______ Zip:______

(circle) Own or Rent - Monthly Rent/Mortgage:______________ (circle) Own or Rent - Monthly Rent/Mortgage:_____________

Yrs at present address/:__________________________ Years at Present Address:______________________

Employer:____________________________________________ Employer:_________________________________________

Position:______________________________________________ Position:___________________________________________

Years with current employer:______________________ ______ Years with current employer:________________________

Monthly Income:_________________________________ _______ Monthly Income:___________________________________

Type of compensation: Salary Commission Self-employed Type of compensation: Salary Commission Self-employed

BUYER’S ASSEST INFORMATION

Funds Available for Down Payment & Closing Costs:____________________ Source of Closing Funds: __________________________

Liquid Assets: Avg. Balance in Checking Account: _________________ Avg. Balance in Savings Account:___________________

Balance in Retirement Funds: ___________________ Balance in Money Market or Mutual Fund:______________

Other Assets (i.e. 401K vested amount, stocks/bonds, CD) :________________________________________________________________________________________

Your signature below will authorize Nationstar Mortgage LLC to pull a residential mortgage credit report.

________________________________________________ ________________________________________________Borrower Date Co-Borrower Date