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Do you wish to: Prequalify for a mortgage      Apply for a mortgage
PERSONAL INFORMATION
Borrower
Information		   Co-Borrower
Information
Full Name
Current Street Address
County, State, Zip
Home Phone (+ area code)
Email Address
Social Security # (REQUIRED)
Borrowers Age:
Are you: Married  Not Married
Total number of people in household:
Have you owned a home in the past 3 years: Yes No
Do you currently own or rent?  Own  Rent
If you own, are you selling this home?  Yes  No
How long have you lived there? (years) 
If you have lived at the current address for less than 2 years,
please give us your former addresses during the last two years:

1)
2)
3)

PROPERTY INFORMATION
Sales/Value Price: Loan Amount:

Purchase  Refinance  Cash Out Refinance

For:  Primary Residence  Second Home  Investment

Number of People in your household:

Select a Loan Type:
Source of Down Payment and Closing Costs (check all that apply)
Savings
Sale of Securities
Sale of Home
Gift
Bridge Loan

Type of Property to be Financed:

Single Family House  Townhome  Condo  2-4 Family 
Construction  Coop
Property Location (County) :
EMPLOYMENT INFORMATION
Borrower   Co-Borrower
Present Employer
Address
City,State,Zip
Telephone
(with area code)
Years on this job
Title
(if self-employed enter "se")
Annual Base Income
Annual Bonus Income
Annual Commissions or
Self Employment Income
FINANCIAL INFORMATION
Liquid Assets
Approx. Balances in Liquid Accounts
In IRA & 401k Accounts
We will follow up later to obtain names and addresses of institutions and account numbers.

Debts
Borrower   Co-Borrower
Mortgage Company
Monthly Payment
Approx Balance
Name of Creditor
Monthly Payment
Approx Balance
Name of Creditor
Monthly Payment
Approx Balance
Name of Creditor
Monthly Payment
Approx Balance
Name of Landlord
Telephone Number
Monthly Rent
Alimony or child support
Monthly Payment
Credit History Is
Borrower   Co-Borrower
Excellent   Excellent
Good - Some Lates   Good - Some Lates
Some Credit Problems   Some Credit Problems
Major Credit Problems   Major Credit Problems
Declarations
Borrower   Co-Borrower
 Yes   No Are there any outstanding judgments against you?  Yes   No
 Yes   No Have you filed for bankruptcy in the past 7 years?  Yes   No
 Yes   No Are you a co-signor or guarantor on any loans?  Yes   No
 Yes   No Are you a US citizen?  Yes   No
SPECIAL INSTRUCTIONS / SUGGESTIONS

Let us know any other issues or questions you may have...


 

 
 
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