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 Comercial/Income Property Real Estate Loan Application 
 Property Owned By 
Business Name
Tax ID
Principals Full Name
Social Security
Principals Full Name
Social Security
Full Name
Social Security
 Mailing Address 
Number
Street
City
State
Zip
Home Phone
Cell Phone
Business Phone
 Type of Property 
No of Units
Property Rental Income
Insurance Expense
Taxes
 Property Address 
Number
Street
City
State
Zip
 Purpose of Loan 
Loan Amount
 Details 
Purchase Price
Projected Rental Income
Projected Expenses
Current Outstanding Mortgage
Original Purchase Price
Maturity
Existing Mortgage Held By
Interest rate
Value of Property
Renovation Cost
Existing Mortgage Amount
Existing Mortgage Terms
Comments
 Residential/Mixed Details 
The following information is requested by the Federal government for certain types of loans related to a dwelling in order to monitor the lender’s compliance with equal credit opportunity, fair housing, and home mortgage disclosure laws. You are not required to furnish this information, but are encouraged to do so. You may select one or more designations for “race”. The law provides that a lender may not discriminate on the basis of this information, or on whether you choose to furnish it. However, if you choose not to furnish the information and you have made this application in person, under federal regulations the lender is required to note ethnicity, race and sex on the basis of visual observation or surname. If you do not wish to furnish the information, please check below.
Applicant
I do not wish to furnish this information
Co-Applicant
I do not wish to furnish this information
 Ethnicity 
 Race or National Origin 
 Sex 
Electronic Signature
 Ethnicity 
 Race or National Origin 
 Sex 
Electronic Signature

 



  
CROWN BANK CORPORATE OFFICE | PRIVACY STATEMENT | TELEPHONE: 1(908) 659-2100 | FAX: 1(908) 289-1601