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Construct Home
Rate/Term - Refinance
Cash Out - Refinance
Home Improvement
Debt Consolidation
Change Loan Type-Refi
Const. to Perm.
Purchase
Other
Loan Amount *
Estimated Closing Time
Immediately
Within 1 month
Within 2 months
More than 3 months
Amortization Type
Fixed Rate
ARM
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Other
Down Payment Amount
Source of Down Payment: *
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Checking/Savings
Deposit on Sales Contract
Equity on Sold Property
Equity from Pending Sale
Equity from Subject Property
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Stocks and Bonds
Lot Equity
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Cash Borrowed
Trust Funds
Retirement Funds
Rent with Option to Purchase
Life Insurance Cash Value
Sale of Chattel
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Other Type of Payment
Secured Borrowed Funds
Property Information
Property Will Be
Primary Residence
Secondary Residence
Investment
Property Market Value / Purchase Price *
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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
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MS
MT
NC
ND
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NH
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PA
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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
$
CO-Borrower Credit history is
Excellent
Good but some lates
Some credit problems
Major credit problems
Unknown
Are you self employed
Select One
----------
Yes
No
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