Application

Application

| | | | | | | | |

There is a $30 application fee if paid by check or cash ($33 if paid via PayPal). You can pay via PayPal at the bottom of this page. PayPal accepts all major credit cards.

What Property are you interested in?

Full Name:

* required

Are you Married?

Co-Applicant (if applicable):

Present Address:

* required

City/St/Zip:

* required

Phone # (home):

* required

Phone (work):

E-mail:

Social Security#:

* required

Co-Applicant's SS#:

Date of Birth (DOB):

* required

Co-Applicant DOB:

How Many in Family?:

How long have you been at current address?:

* required

Current Rent Amount $:

* required

Name of Present Landlord:

* required

Landlord Phone #:

* required

Current Employer:

* required

Employer Supervisor:

* required

Employer Phone#:

* required

How Long have you been employed by this company?

* required

Income per month:

* required

Co-Applicant's Present Employer:

Co-Applicant's Employer Supervisor:

Co-Applicant's Employer Phone#:

Co-Applicant's- How long have you been employed with this company?:

Name of Bank:

* required

Bank Phone#:

* required

Bank Account#:

* required

Automobile (make / model / year):

* required

Automobile License Plate# / State:

* required

Any additional vehicles (motorcycle, boat, etc.)?:

* required

Personal Reference#1 (name & phone#):

* required

Personal Reference #2 (name & phone#):

* required

Is there any additional information that would effect the eligibility of your application?

Date of this Application:

* required

By typing your name in this space, you are hereby siging this document electronically:

* required

Co-Applicant: By typing your name in this space, you are hereby siging this document electronically:

I represent that the information provided above in this application is true to the best of my knowledge. You are hereby authorized to verify my credit and employment references in connection with the processing of this application. I acknowledge receipt of a copy of this application.

After you have submitted the application above, please send a check for $30 to Hamele Family Investments, LLC, 315 E. Wisconsin St., Portage, WI 53901 -OR- click on the "Buy Now" button below to pay $33 with a credit card via PayPal.