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Property Type
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Single Family Detached
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Commercial Property
Borrower Name
Borrower Home Phone
Borrower Cell
Borrower Work Phone
Borrower E-Mail Address:
Borrower Employment Status:
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Employed Full Time
Employed Part Time
Retired
Disabled
Borrower Annual Income
Is There a Co-Borrower?
YES No
If Yes, Please Complete Co-Borrower Info Below
Co-Borrower Name
Co-Borrower Home Phone
Co-Borrower Cell Phone
Co-Borrower Work Phone
Co-Borrower E-Mail Address:
Co-Borrower Employment Status:
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Employed Full Time
Employed Part Time
Retired
Disabled
Co-Borrower Annual Income
Property Address Street
City
State
ZIP
Current 1st Mortgage Amount
Current Balance
Payment
Current 2nd Mortgage Amount
Current Balance
Payment
Is your 1st Mortgage Currently Escrowed for Taxes & Insurance:
YES
NO
What Are Approximate Annual Amounts for :
Property Taxes
Homeowners Insurance
Have You Ever Filed Bankruptcy
YES NO
If YES, How Long Ago Was It Discharged?
If NO, Please Enter NA
Any Foreclosures?
YES NO
If YES, How Long Ago?
If NO, Please Enter NA
RateYour Credit on a Scale from A- D ( A Being Best )
A B C D
Do You Know Your Credit Score (Approximate)
What Are Your Approximate Asset Balances Total ( Including Checking, Savings, 401K, IRA, Mutual Funds, Stocks, Bonds, Money Market, Cash Value of Life Insurance)
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