Personal info:

Your first & last name:

Street Address:

City

State:

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Zip

Phone Number:

Email Address:

Preferred Contact Method:

Phone Email Fax

Best Time to Reach You:

AM PM

Loan Information

If Purchase:

Property Type

Primary Residence Second Home Investment Property

Timeframe to Purchase:

Purcahse price:

$

Requested Loan Amount:

$

Secondary Loan Amount:

$

Financing Needs:

Low Down Payment Flexible Credit History Guidelines Minimal Out of Pocket Costs New Construction Financing

If Refinance:

Estimated Property Value:

$

Estimated Loan Amount:

$

Current First Mortgage - Monthly Payment:

$

Current First Loan Amount:

$

Current Second Loan - Monthly Payment

$

Current Second Loan Amount:

$

Use of Cash Out:
(If applicable)

Financing Needs

Cash Out No Out of Pocket Costs Flexible Credit History Guidelines

Income Information

Income

Borrower

Co-Borrower (If applicable)

Gross Annual Income:

$

$

Other Income:
Rental, dividend, interest, child support, alimony, etc.

$

$

Total Income:

$

$

Do You Own 25% or Greater of Your Business?

Yes No

Yes No

Debts

Monthly Credit Card total Minimum payment(s) Due for Card(s) With Outstanding Balance:

$

$

Total Monthly Auto Loan/Lease Payment(s):

$

$

Number of Months left on Loan/Lease:

$

$

Total Other Monthly Installment Payments:
Student Loans, consumer loans, etc.

$

$

Othert:
Alimony, child support, insurance, taxes, etc.

$

$

Total Debt:

$

$

Existing Mortgage

First Mortgage Payment:
(If you do not have a first mortgage, or it will be paid off upon sale of your residence to purchase new home, write NONE)

$

Does Your Mortgage Payment Include Tax & Insurance?

Yes No

If No, What is Your Annual tax and insurance cost?

Other Mortgage(s) Monthly Payment(s):
Equity Lines, seconds, etc.

$

Checking:

$

Savings:

$

Other:

$

Any Questions or comments:

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