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Borrower |
Co-Borrower (optional) |
| Full Name |
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| Email |
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| Address |
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| City |
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| State |
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| Estimated Value: |
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Current Loan Amount: |
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| Cash Requesting: |
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Current Interest Rate: |
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Loan Request
Purchase Refinance
Cash Out
Refinance
For:
Primary Residence Second
Home Rental
Loan Type
Fixed
Rate 30 Fixed Rate
15 ARM Balloon
Type of Property
Single Family Home Townhome/
Condo
Manufactured Home |
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Borrower |
Co-Borrower (optional) |
| Present Employer |
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Number
(w area code) |
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| Years on This job |
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| Annual Base Income |
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| Annual Bonus Income |
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| Commissions or Self Employment Income |
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| Approx. Balances in Liquid Accounts |
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In IRA & 401k Accounts |
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| Borrower |
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Co-Borrower |
Excellent
Good -
Some Lates
Some
Credit Problems
Major
Credit Problems |
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Excellent
Good -
Some Lates
Some
Credit Problems
Major
Credit Problems |
| Borrower |
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Co-Borrower (optional) |
| Yes No |
Are there any outstanding judgments against you? |
Yes No |
| Yes No |
Have you filed for bankruptcy in the past 7 years?
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Yes No
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