American General Financial Services
Office Phone# (610)394-3875 Fax Number (610)394-0187
Barclay Square Shopping Center
1500 Garrett Road Suite F
P.O. Box 218
Upper Darby, PA 19082-0218
Home Improvement Loan Application
Date____/_____/2011
Amount Requested Prime Contractor Name
$_______________ Abc General Contractors
(267) 269-3416
Home Phone: ( ) -
Cell Phone: ( ) - (Please print clearly)
First Name Middle Name Last Name ______________________l______________________________l_______________________________
Date of Birth: Social Security# Driver License#
_____/______ /________ _______-_____-_______ State____ ________________
Address Information:
Street: City: State: Zip Code:
l ____________________l________________l__________________l_____________
Mortgage Information:
Own: ____ Monthly Mortgage Payment: $________
Current Income Status:
Pension Social Security Self Employed Employed FT PT
$____________ $__________ $___________ $______________ [ ] [ ]
Employer Name: ______________________ Position: ________________ Start Date:
Net Pay Per Period:
Weekly [ ] Biweekly [ ] Monthly [ ] Bimonthly [ ]
This home improvement loan was prepared for the purpose of showing loan applicant has the ability to repay
the loan and induce the loan corporation to make the loan.
I /We ______________________________________ have reviewed this application and it is correct.
Applicant Signature
1. CALL FOR FREE ESTIMATE : Nathaniel Minor (267) 269-3416
2. FAX APPLICATION TO: (610) 394-0187
email:nate.minor@hotmail.com