*Social Security #   Example: XXX-XX-XXXX

*email address:

In what state and city is the subject property located?

State: ALAKAZARCACOCTDEDCFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPAPRRISCSDTNTXUTVTVAWAWVWIWY City:

What Type of Loan are you interested in? (Check all that apply)

Conventional VA FHA Fixed Rate Adjustable Rate

What is the purpose of obtaining the mortgage?

Purchase Rate and Term Refinance Cash out / Home Repair Refinance

Do you currently Own  Rent

Approximately how large of a mortgage are you interested in obtaining?
   Loan Amounts under 100,000 may be subject to higher rates.

$175,001 to $200,000 $200,001 to $250,000 $250,001 to $300,000 $300,001 to $350,000 $350,001 to $400,000 $400,001 to $500,000 over $500,000 $150,001 to $175,000 $140,001 to $150,000 $130,001 to $140,000 $120,001 to $130,000 $110,001 to $120,000 Select

How much of a down payment are you willing to invest? If you are refinancing, how much equity will you have in your home after this refinance (property value less the above loan amount)?

20% 15% 10% 25% 30% or greater 5% Select

What is your approximate gross (before tax) monthly income? (Include spouse.) If you have rental income, subtract any mortgage payments and maintenance costs before adding it to your income. (Do not include the rental / mortgage payment in your debts listed below).

  Monthly Income

How much do you pay each month on other debts - minimum payments only. Please do not include payments such as insurance, rent, or non debt related expenses. Do however include alimony and /or child support that you are obligated to pay. Also include credit cards, student loans, car loans, personal loans, etc...

  Monthly Debt

If you are self employed, please check this box
(Self employed borrowers may need additional phone consultation).

Occupation:

Length of time with current employer more than two years 1 to two years less than 1 year Select

Length of time in line of work more than two years 1 to two years less than one year Select

*If Refinancing complete this section:

       Occupancy Type: Primary Residence Second Home Non Owner/Investment Select

       Purchase Price of Your Home    Example: 110,000

       Date Property was Acquired     Example: 7/2000

       Present Value of Property     (Approximate Appraised Value)

       Current Balance of First Mortgage 

       Current Interest Rate of First Mortgage  %

       Current Balance of Second Mortgage 

       Current Interest Rate of Second Mortgage  %

    _____________________________________________________

Please enter any additional information or comments below that you feel may be helpful. For example - if you have had credit problems in the past, please explain the situation and the approximate time period in which it occurred.

Please note that Step 2 will require you to FAX the Necessary Documentation so we can Process your request to Pre-Approve your loan in just 48hrs!

Thank you! Please press the Submit button to continue.