Mortgage Loan Application Form
Applicant First Name:
*
Applicant Last Name:
*
At least one phone number is required (Home phone or Work phone)
Home Phone:
*
Work Phone:
*
Mobile Phone:
Email:
*
Street Address:
*
City:
*
State:
- select state -
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
*
ZIP:
*
Best Time To Contact:
Anytime
Morning
Afternoon
Evening
Best Place To Contact:
Anywhere
At Home
At Work
Loan Type:
- please select -
Refinancing a Home
Refinancing a Home VA
New Home Purchase
New Home Purchase VA
Second Mortgage
FHA Refinance
New FHA Purchase
Reverse Mortgage
*
Property Type:
- please select -
Single-family
Townhouse
Multiple-family dwelling
Condo
Coop
Manufactured/Mobile Home on your Land
Manufactured/Mobile Home on rental lot
Undeveloped Vacant Land
Commercial
*
Need extra money to pay off debt?
No
Yes
Amount of Cash Out:
Desired Loan Amount:
- please select -
$50,000
$55,000
$60,000
$65,000
$70,000
$75,000
$80,000
$85,000
$90,000
$95,000
$100,000
$110,000
$120,000
$130,000
$140,000
$150,000
$160,000
$170,000
$180,000
$190,000
$200,000
$210,000
$220,000
$230,000
$240,000
$250,000
$260,000
$270,000
$280,000
$290,000
$300,000
$320,000
$340,000
$360,000
$380,000
$400,000
$420,000
$440,000
$460,000
$480,000
$500,000+
*
Approximate Property Value:
- please select -
$50,000
$55,000
$60,000
$65,000
$70,000
$75,000
$80,000
$85,000
$90,000
$95,000
$100,000
$105,000
$110,000
$115,000
$120,000
$125,000
$130,000
$135,000
$140,000
$145,000
$150,000
$155,000
$160,000
$165,000
$170,000
$175,000
$180,000
$185,000
$190,000
$195,000
$200,000
$205,000
$210,000
$215,000
$220,000
$225,000
$230,000
$325,000
$240,000
$245,000
$250,000
$255,000
$260,000
$265,000
$270,000
$275,000
$280,000
$285,000
$290,000
$295,000
$300,000
$305,000
$310,000
$315,000
$320,000
$325,000
$330,000
$335,000
$340,000
$345,000
$350,000
$355,000
$360,000
$365,000
$370,000
$375,000
$380,000
$385,000
$390,000
$395,000
$400,000
$405,000
$410,000
$415,000
$425,000
$425,000 - 450,000
$450,000 - 475,000
$475,000 - 500,000
$500,000 - 550,000
$550,000 - 600,000
$600,000 - 650,000
$650,000 - 700,000
$700,000 - 750,000
$750,000 - 800,000
$800,000 - 850,000
$850,000 - 900,000
$900,000 - 950,000
$950,000 - 1,000,000
$1,000,000 +
*
Property Location State:
- select state -
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
*
Do you own the property?
No
Yes
Property Purpose:
Purchase Time Frame:
Estimated Down Payment:
Credit History:
- please select -
Excellent
Good
Fair
Poor
*
First Mortgage Balance:
Second Mortgage Balance:
First Mortgage Rate:
- please select -
5%
5.25%
5.5%
5.75%
6%
6.25%
6.5%
6.75%
7%
7.25%
7.5%
7.75%
8%
8.25%
8.5%
8.75%
9%
9.25%
9.5%
9.75%
10%
10.25%
10.5%
10.75%
11%
11.25%
11.5%
11.75%
12%
12.25%
12.5%
12.75%
13%
13.25%
13.5%
13.75%
14%
14.25%
14.5%
14.75%
15%
15.25%
15.5%
15.75%
16%
16.25%
16.5%
16.75%
17%
17.25%
17.5%
17.75%
18%+
Second Mortgage Rate:
- please select -
5%
5.25%
5.5%
5.75%
6%
6.25%
6.5%
6.75%
7%
7.25%
7.5%
7.75%
8%
8.25%
8.5%
8.75%
9%
9.25%
9.5%
9.75%
10%
10.25%
10.5%
10.75%
11%
11.25%
11.5%
11.75%
12%
12.25%
12.5%
12.75%
13%
13.25%
13.5%
13.75%
14%
14.25%
14.5%
14.75%
15%
15.25%
15.5%
15.75%
16%
16.25%
16.5%
16.75%
17%
17.25%
17.5%
17.75%
18%+
First Mortgage Type:
- please select -
Fixed
Adjustable
Baloon
Second Mortgage Type:
- please select -
Fixed
Adjustable
Baloon
1
st
Mortgage Monthly Payment:
2
nd
Mortgage Monthly Payment:
Employed:
Yes
No
Self Employed:
No
Yes
Years at Current Employer:
Monthly Income:
Monthly Expenses: