Mortgage Information
Loan Purpose
New
Home
Construction
Rate
/
Term
-
Refinance
Cash
Out
-
Refinance
Home
Improvement
Debt
Consolidation
Change
Loan
Type-Refi
Const.
to
Perm.
Purchase
Purchase/Refi
in
Name
of
Corp/LLC/LLP
Loan Type
Conventional
VA
Loan
FHA
Loan
FarmHA
Loan
Other
Loan
Amortization Type
Fixed
Rate
COFI
loan
ARM
GPM
Loan Amount *
Interest Rate
5.125
5.250
5.375
5.500
5.625
5.750
5.875
6.000
6.125
6.250
6.375
6.500
6.625
6.750
6.875
7.000
7.125
7.250
7.375
7.500
7.625
7.750
7.875
8.000
8.125
8.250
8.375
8.500
8.625
8.750
8.875
9.000
9.125
9.250
9.375
9.500
9.625
9.750
9.875
10.000
10.125
10.250
10.375
10.500
10.625
10.750
10.875
11.000
11.125
11.250
11.375
11.500
11.625
11.750
11.875
Estimated Closing Time
Immediately
Within
1
month
Within
2
months
More
than
3
months
Down Payment Amount
Source of Down Payment:
Checking/Savings
Deposit
on
Sales
Contract
Equity
on
Sold
Property
Equity
from
Pending
Sale
Equity
from
Subject
Property
Cash-Gift
Stocks
and
Bonds
Lot
Equity
Financing
Secured
Property
Cash
Borrowed
Trust
Funds
Retirement
Funds
Rent
with
Option
to
Purchase
Life
Insurance
Cash
Value
Sale
of
Chattel
Cash
on
Hand
Pledged
Collateral
Property Information
Property Will Be
Primary
Residence
Second
Home
Investment
Property Market Value
Address
City
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
PR
RI
SC
SD
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
Zip
Borrower Information
First Name *
M. Last Name *
Social Security Number *
Address *
City * State
*
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
PR
RI
SC
SD
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
Zip *
Email address *
Work Phone *
Home Phone *
Borrowers Current Employer
Time with employer
Years Months
Gross Monthly Income
$
Borrower Credit history is
Excellent
Good but some lates
Some credit problems
Major credit problems
Unknown
Are you self employed
Select
One
----------
Yes
No
Co-Borrower Information
First Name
M. Last Name
Social Security Number
Address
City
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
PR
RI
SC
SD
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
Zip
Email address
Work Phone
Home Phone
CO-Borrowers Current Employer
Time with employer
Years Months
Gross Monthly Income
$
Borrower Credit history is
Excellent
Good but some lates
Some credit problems
Major credit problems
Unknown
Are you self employed
Select
One
----------
Yes
No