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Name: Social Security Number (optional): Home Phone: Fax Number: Work Phone: E-mail: Best time to reach me:
City: State:
Purchase Refinance Credit Line Home Improvement Other, please describe:
Loan amount desired is $
30 yr fixed 15 yr fixed 30/5 yr fixed 30/7 yr fixed Adjustable Haven't decided Other, please state:
Annual household income is $ My credit history is excellent good, but some lates some credit problems major credit problems don't know
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FILL THIS OUT IF PURCHASING A HOME
Please skip to the next section if refinancing
Thinking about it Actively Looking About to make an offer Have a sales contract
I am working with a Realtor Please refer me to a Realtor I am buying directly from the seller I am buying directly from the builder
I expect to buy a home between $ and $
I expect to put between % and % down
FILL THIS OUT ONLY IF REFINANCING
Please skip to the next section if applying for a second mortgage
The property should appraise for $ Don't know
1st loan balance $ 2nd loan balance $ 3rd loan balance $
Reduce Interest rates Change from fixed to adjustable Change from adjustable to fixed Need cash out. Cash out required $ Other, please specify:
Fixed Adjustable Other, please specify:
FILL THIS OUT IF REQUESTING A SECOND MORTGAGE, CREDIT LINE, or HOME IMPROVEMENT LOAN
credit line fixed 2nd mortgage Other, please specify:
1st loan $ 2nd loan $ Do any of the loans have negative amortization? Yes No Don't Know
home improvement pay off bills Other, please specify:
b
y