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Mortgage Application
Instructions:
  1. Complete the General Section.
  2. Complete the section that applies to your needs:
    • The Purchase Section only if buying a home.
    • The Refinance Section only if refinancing.
    • The Second Mortgage Section if applying for credit line/equity loan.
  3. Click on the Send Request button.

I will be in touch with you shortly to discuss your financing options.

General Section
Contact Information
Your Name:
Home Telephone:
Work Telephone:
E-mail Address:
Best Time to Reach Me:
Property Location
City:
State:
Loan Information
Loan Request: Purchase
Refinance
Credit Line
Home Improvement
Other, please describe:  
Loan Amount Desired: $
Type of Loan Desired: 30 yr fixed
15 yr fixed
30/5 yr fixed
30/7 yr fixed
Adjustable
Haven't decided
Other, please state:  
Personal Information
Annual Household Income: $
My Credit History: Excellent
Good, but some lates
Some credit problems
Major credit problems
Don't know 

Purchase Section
FILL THIS OUT IF PURCHASING A HOME

Please skip to the next section if refinancing.

Time Frame: Thinking about it
Actively Looking
About to make an offer
Have a sales contract
Real Estate Professional Information: I am working with a Real Estate Professional
Please refer me to a Real Estate Professional
I am buying directly from the seller
I am buying directly from the builder
Purchase Price: I expect to buy a home between $ and $
Down Payment: I expect to put between  % and  % down 

Refinance Section
FILL THIS OUT ONLY IF REFINANCING

Please skip to the next section if applying for a second mortgage.

Property Value: The property should appraise for $
Don't know
Existing Loans on Property: 1st loan balance $
2nd loan balance $
3rd loan balance $
Reason for Refinancing: Reduce Interest rates
Change from fixed to adjustable
Change from adjustable to fixed
Need cash out.Amount: $
Other, please specify...  
Current Loan Type: Fixed
Adjustable
Other, please specify...  

Second Mortgage Section
FILL THIS OUT IF REQUESTING A SECOND MORTGAGE, CREDIT LINE, OR HOME IMPROVEMENT LOAN.
Type of Loan: Credit line
Fixed 2nd mortgage
Other, please state...  
Existing Loans on Property:
1st loan $
2nd loan $
Do any of the loans have negative amortization?
Yes
No
Don't know
Reason for Loan: Home improvement
Pay off bills
Other, please specify...  

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