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* Enter Your E-mail Address: (Required field) 
If you are in contact with a loan officer or interviewer, enter their name below:
Loan Officer or Interviewer's Name:

The income or assets of a person other than the "Borrower" (including the Borrowers spouse) will be used as a basis for loan qualification.
  The income or assets of the Borrower's spouse will not be used as a basis for loan qualification.

Loan Applied
For:(Choose one)
V.A
Conventional
Other
FHA
USDA/Rural Housing Service
If Other (Type)
Loan, Tax & Insurance Information
Amount Applied For:
$
Interest Rate: 
  
Number of Months:
 
Yearly Taxes:
$
Yearly Insurance:
$
Amortization Type:
(Choose one)
Fixed Rate
Other
If Other (explain)
 
GPM
ARM
If ARM (type)


  Subject Property Address:
Street:
 
City, State, Zip: 
APN or Parcel Number: 
Number of Units: 
     Year Built:

Purpose of Loan:  (Choose one)
 
Purchase
Construction
Other
 
Refinance
Constr.-permanent
  If other (explain)

Property will be: (Choose one)
 
Primary Residence 
Secondary Residence 
Investment 

Complete below if construction or construction-to-permanent loan
Year Lot Acquired: 
Original Cost: $ 
Amount Existing Liens: $ 
Value of Lot: $ 
Cost of Improvements: $ 
Total Value: $ 

Complete below if this is a refinance loan
Year Acquired: 
Original Cost: $ 
Amount Existing Liens: $ 
Purpose of Refi: 
Imprvements made:
To be made:
Cost of Improvements: $
 
Please Describe improvements (if any):

Title will be held in what names (enter below):
 
Manner in which title will be held (enter below):
 
Source of Down Payment, Settlement Charges and/or Subordinate Financing:
Please explain: 
 
Estate will be held in:  Fee Simple:  Leasehold: 
  If Leasehold Estate, enter expiration date:



 
Enter Borrower's Name Below (include Jr. or Sr. if applicable)
First Name:  
Mi.:
Last Name:
 
Soc. Sec. No.:  
 Home Phone:

DOB (mm/dd/yyyy):  Pick a date
Yrs. in School:  
   Marital Status: Married   Separated   Unmarried (includes single, divorced, widowed)

  Dependents: (How many?)    What are their ages?

NOTE:
   If Borrower address is the same as Subject Property address, check the box:
Present Address:
 
Street: 
Own:  Rent:
 
City, State, Zip: 
  Number of years:
If Mailing Address is different than Present Address above, click "Yes":   Yes:    No:

If residing at Present Address for less than two years, complete the following:
Former Address: 
  Street:  Own:    Rent: 
  City, State, Zip:  Number of years:



NOTE:
  If Co-Borrower information is the same as Borrower, check the box:
  Enter Co-Borrower's Name Below (include Jr. or Sr. if applicable)
First Name:  
Mi.:
Last Name:
 
Soc. Sec. No.:  
 Home Phone:

DOB (mm/dd/yyyy):  Pick a date
Yrs. in School:  
   Marital Status:   Married   Separated   Unmarried   (includes single, divorced, widowed)

  Dependents: (How many?)    What are their ages?

Present Address:
 
Street: 
 Own:  Rent:
 
City, State, Zip: 
 Number of years:
If Mailing Address is different than Present Address above, click "Yes":   Yes:    No:

If residing at Present Address for less than two years, complete the following:
Former Address:
 
Street: 
 Own:  Rent:
 
City, State, Zip: 
 Number of years:




      Borrower   Co-Borrower
Employer Name: 
 
Street Address: 
 
City, State, Zip: 
 
Work Phone: 
Position/title: 
 
Business Type: 
Self Employed?: 
  Yes: No:  Yes:   No:
 
Years on Job: 
 
Yrs. in profession: 
NOTE: If you have been employed in this position for less than two years or you are currently employed in more than one position, Click "Yes" at the right and continue. Yes:    No: