The Massachusetts Police Association Home Mortgage Program | Massachusetts
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Short Application Form

*Required Fields
Personal Information  
* First Name:
* Last Name:
* Email:
Home Phone:
Cell Phone:
Work Phone:
Martial Status:
Are you a US Citizen?
Date of Birth:
* Social Security or Tax ID#:
Number of Dependents:
Dependent Age(s):
Current Address  
Street Address:
Years at this Address:
Rent or Own:
Subject Property  
Purpose of Loan:
Property Usage:
Loan Amount:
Purchase Price:
Number of Units:
Year Built:
Subject Property Address:
Monthly Income  
Submitting income from alimony, child support, or separate maintenance income is optional if you do not want to use that income for qualification purposes
Base Income:
Other Income:
Retirement Funds:
Mutual Funds:
Information for Government Monitoring Purposes
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.
Option: I do not wish to furnish this information
Sex: Male Female
Ethnicity: Hispanic or Latino
Not Hispanic or Latino
Race: American Indian or Alaska Native
Black or African American
Native Hawaiian or Other Pacific Islander
Not Applicable
Decline to State
* Privacy Policy  
We take our clients' financial privacy very seriously. During the course of processing your application, we accumulate non-public personal financial information from you and from other sources about your income, your assets, and your credit history in order to allow a lender to make an informed decision about granting you credit. We restrict access to nonpublic personal information about you to those employees who need to know that information to provide products or services to you. We maintain physical, electronic, and procedural safeguards that comply with federal regulations to guard your nonpublic personal information.

We collect nonpublic information about you from the following sources: (i) information we receive from you on applications or other forms; (ii) information about your transactions with us, our affiliates, or others; and (iii) information we receive from a consumer reporting agency.

We do not disclose any nonpublic information about our customers or former customers to any third party, except as permitted by law.
I accept the terms of the privacy policy
Co Borrower  
Do you have a co-borrower? Yes No