Type of Mortgage and Terms of Loan
Amount Desired
Desired Rate:
Loan Length Amortization Type:
Fixed Rate GPI
ARM  
Other
Property Information and Purpose of Loan
Subject Property Address
# of Units
Legal Description of Property
Year Built
Purpose of the Loan
Purchase Refinance ConstructionConstruction-Permanent Other
Property will be:
Primary Residence Secondary Residence Investment
Complete this line if construction or construction permanent
Year Lot Acquired Original Cost Amount Existing Liens (a)Present Value of Lot (b)Cost of Improvements Total(a+b)
Complete this line if refinancing
Year Acquired Original Cost Amount Existing Liens Purpose of Refinance Cost of Improvements
Made To Be Made
Title will be held in what name(s)
Estate will be held in:
Fee Simple
Leasehold
Source of Down Payment, Settlement Charges and/or Subordinate Financing
Information
Borrower's Name(include Jr., Sr., etc)
Co-Borrower's Name(include Jr., Sr, etc.)
Social Sec. #
Home Phone
Age
Yr School
Social Sec. #
Home Phone
Age
Yr School
Married
Separated
Unmarried
Dependents' Ages (not listed by co-borrower)
Married
Separated
Unmarried
Dependents' Ages (not listed by borrower)
Current Address(street, city , state, zip)

Rent Own # of Years
Current Address(street, city , state, zip)

Rent Own # of Years
If residing at present address for less then 2 years, complete the following
Former Address (street, city , state, zip)

Rent Own # of Years
Former Address (street, city , state, zip)

Rent Own # of Years
Borrower Co-Borrower
Name of Employer

Address of Employer
Name of Employer

Address of Employer
Self Employed Self Employed
Yrs. at Job: Years in Profession: Yrs. at Job: Years in Profession:
Position/Title/Type of Business Position/Title/Type of Business
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email
Your email address

Date of Birth of borrowers