The Borrower

Are you applying with a co-borrower?
Yes No
First Name:
Last Name:
Day Phone:
ex: 555-555-5555
Evening Phone:
ex: 555-555-5555
Email Address:
Cell Phone:
  I prefer to be contacted by:
  The best time to reach me is:

Property Type:

Property Use:

Property Address: (Please do not use abbreviations.)

City: County:

Questions for the Borrower

What is your employment status?
Answer the following questions if you selected  Employed or Self-Employed.
What is the name of your company/ employer?
What is your title or position?
How long have you been with your current employer?
Previous employer (If less than 2 years)
What is your gross annual income?
$ .00
Do you rent or own your current home?
What is your current monthly rent or mortgage payment?
$ .00
First mortgage balance?
$ .00
Do you have a 2nd mortgage (yes or no)
Yes No
2nd Mortgage Payment
$ .00
2nd mortgage Balance
$ .00
Have you filed for bankruptcy in the last 4 years?
How would you describe your credit history?


Some Credit Problems
Many Credit Problems
Special Circumstances

Please list your liabilities (Include balance and payment.):
Please list your assets (Include balance.):
If you have additional notes that you feel will help your loan officer to assist you,
you may type them in the box below. (Maximum 250 characters.)
The sooner we can review your credit history, the faster we qualify you for a loan.   I authorize to request a copy of my credit report (and my co-borrower's credit report, if applicable) so that I can be pre-approved for a loan as soon as possible.
I accept the terms and conditions of your privacy policy.


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