First name
Last name
Street address
Address (cont.)
City
State/Province
Zip/Postal code
Work Phone
Home Phone
Best time to Call AM
PM
E-mail
Transaction Type
Choose
a transaction type
Purchase
Refinance
Purchase Price
Loan Amount
Total Minimum Credit Card, Auto, Mortgages, Student loans.
Gross Monthly Income
Purpose of Loan
Select Appropriate Loan Purpose from this list
Purchase - Sales Contract on property
Purchase - Credit Approval ONLY
Rate and Term Refinance
Cash Out Refinance
Home Equity Loan
Home Improvement Loan
Other
Property Type
Choose Property Type
1 Family
2 Family
3 Family
4 Family
Program Desired
Choose Desired type of Loan
30 Year Fixed
15 Year Fixed
1 Year Adjustable
3 Year Adjustable
5 Year Adjustable
No-Income/No-Asset Verfication
125% 2nd
100% Financing
Foreign National
Condo/Hotel
Non Owner Occupied Investor
Debt Consolidation
Commercial
Other
Condition of Credit
Rate your credit on a scale from 1-10 (
excellent=10)
9-10
6-8
3-5
1-2
Self Employed?
Bankruptcy, Tax Liens
Bankruptcy discharged
Please add any information you feel may be of importance in
determining your loan application approval.
