GENERAL INFORMATION

Loan Type: New Purchase Refinance Home Equity
Loan Term Requested: 15 Year Fixed 30 Year Fixed Adjustable Not Sure (For New Purchase, Refinance)

Loan Amount Requested:

IF NEW PURCHASE :
Are you a first time home buyer? yes No
When do you plan to purchase?
I’ve found a house already
I’m shopping right now
As soon as possible
2 to 4 months
About 6 months
Don’t know

Have you begun working with a Realtor? yes no

Property Type:
Single Family Residence
Mobile Home with Land
Mobile Home without Land
Condo/Townhouse
2-4 Unit Residential Complex

Property Use:
My Primary Home
My Second/Vacation Home
Rental/Investment Property

Home Purchase Price: $

Planned Down Payment:
I am interested in a zero down (100%) loan.
I have 5% available to put down.
I have 10% available to put down.
I have 15% available to put down.
I have 20% available to put down.
I have over 20% available to put down.

Source of Down Payment:
I have no down payment.
I have it in my checking/savings account.
It is a gift from a direct relative.
I am borrowing it from my IRA, 401K, etc.

Down Payment: $

Loan Amount: $
(After Down Payment)

If Refinance (Not New Purchase):

Goal of Refinance:
Refinance 1st Mortgage at current balance
Refinance 1st Mortgage and take cash out
Convert from variable to fixed
Combine 1st and 2nd Mortgage into a 1st

Are you interested in taking cash out? yes no
If so, How much? $

IF HOME EQUITY OR LINE OF CREDIT

Planned Loan Use:
Home Improvement
Debt Consolidation
Cash in Hand
Line of Credit

IF REFINANCE, HOME EQUITY, LINE OF CREDIT

Date you originally purchased home (Month/day/year)
Original home purchase price $
Current approximate value of home $

How did you determine value?
Current Appraisal
Realtor Opinion
Tax Assessment
Other

Current Balance of 1st Mortgage: $
1st Mortgage Interest Rate:
Monthly Payment on 1st Mortgage:
Does this include Property Taxes? yes no
Property Taxes Payment $ Annual Monthly
Do you have a 2nd Mortgage? yes no
Current Balance of 2nd Mortgage $
2nd Mortgage Interest Rate
Monthly Payment on 2nd Mortgage $

BORROWER INFORMATION (also complete Co-Borrower section if applicable)
Borrower Name
Address
City
State
Zip
Home Telephone:
Alternate Telephone
Fax Number:
E-Mail Address:
Date of Birth (Month/day/year)
Social Security Number
Self Employed? yes no
How’s your Credit Rating?
Perfect!
Very Good! (1 or 2 minor incidences)
Not Too Bad! (a few minor incidences)
Not Very Good! (collections, mortgage late, etc.)
Help! (bankruptcy, foreclosure, tax liens)

Employer Name:
Employer Address:
Employer City:
Employer State:
Employer Zip Code:
Employer Telephone:
Job Title/Position
Length at Current Employment:
Length at Current Position:
Pre-Tax Monthly Income: $
Total of All Borrower Monthly Debt Payments: (cars, boats, credit cards, alimony, other property, etc.) $

CO-Borrower Information
CO-Borrower Name:
Address:
City:
State:
Zip:
Home Telephone:
Alternate Telephone:
Fax Number:
E-mail Address:
Date of Birth: (Month/day/year)

Social Security Number
Self Employed? yes no
How is your credit rating?
Perfect!
Very Good! (1 or 2 minor incidences)
Not Too Bad! (a few minor incidences)
Not Very Good! (collections, mortgage rates, etc.)
Help! (bankruptcy, foreclosure, tax liens)

Employer Name:
Employer Address:
Employer City:
Employer State:
Employer Zip Code:
Employer Telephone:
Job Title/Position
Length at Current Position
Pretax Monthly Income:
Total of All CO-Borrower Monthly Debt Payments (cars, boats, credit cards, alimony, other property, etc.) $

FINANCIAL INFORMATION (tell us about each significant account you have include bank, saving, credit union, IRA, etc.)
Financial Institution Name 1:
Address
City
State
Zip
Account Type checking savings brokerage IRA, 401K, retirement
Account Number
Account Balance $

Financial Institution Name 2
Address
City
State
Zip
Account Type checking savings brokerage IRA, 401K, retirement
Account Number
Account Balance

Financial Institution Name 3
Address
City
State
Zip
Account Type checking savings brokerage IRA, 401K, retirement
Account Number
Account Balance

Financial Institution Name 4
Address
City
State
Zip
Account Type checking savings brokerage IRA, 401K, retirement
Account Number
Account Balance

OTHER ASSETS
Do you own property? yes no

If you own other property:

Other Property Type
Primary Home
Second/Vacation Home
Rental Investment Property

Other Property Current Value $
Other Property Current Debt $

If Rental or Investment Property:
Monthly Rent or Income $

Other Information or Comments
(Please tell us anything else we should know in order to help serve you better)

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