Mortgage Information

Loan Purpose

Loan Type

Amortization Type

Purchase Construct Home Refinance - No Cash Out Refinance - Cash Out Refinance - Home Improve Refinance - Debt Cons. Refinance - Change Loan Type Construct to Permanent Other Loan Purpose

30 Year Fixed 25 Year Fixed 20 Year Fixed 15 Year Fixed 10 Year Fixed 5 Year Balloon / ARM 7 Year Balloon / ARM FHA - 30 Year Fixed VA - 30 Year Fixed

Fixed Rate ARM Graduated Payment Other

Loan Amount *

Interest Rate

Est. Closing Time

Immediately Within 1 Month Within 2 Months More Than 3 Months

Down Payment Amount

Source of Down Payment *

Select One Check / Savings Equity on Sold Property Equity on Pending Sale Cash - Gift Cash Borrowed Trust Fund Retirement Fund Cash on Hand

Property Information

Property Will Be

Property Market Value / Purchase Price *

Primary Residence Secondary Residence Investment Property

Address

City, State & Zip

Borrower Information

First Name & Middle Initial *

Last Name *

Social Security Number *

Address *

City, State & Zip *

Email Address *

Work Phone *

Home Phone *

Borrower’s Current Employer

Time With Employer
(yrs & months)

Gross Monthly Income *

Rate Your Credit History *

Are you self-employed

Excellent Good But Some Lates Some Credit Problems Major Credit Problems Unknown

No Yes

Co-Borrower Information

First Name & Middle Initial

Last Name

Social Security Number

Address

City, State & Zip

Email Address

Work Phone

Home Phone

CO-Borrower’s Current Employer

Time With Employer
(Yrs & Months)

Gross Monthly Income

CO-Borrower’s Credit History

Are You Self Employed

Excellent Good But Some Lates Some Credit Problems Major Credit Problems Unknown

No Yes