E-Mail Address:                                                       
First:         Last:   
Address:    
City:  
State:  
Zip Code:            
Home Phone:     
  Work Phone:      
Cell Phone :      
Fax :   
Please Contact Me At:    Home   Work     Cell   
Current Housing:  Own        Rent Mthly Housing Pmt: 
How Did You Hear of Us? :  BankRate   Newspaper   Real Estate Mag  Friend     Other

Transaction Information
Are you a First Time Buyer:   Yes          No  

Transaction Type:  

  

Occupancy:  

Primary Residence     Vacation  Home     Investment 

Doc Type:  

Loan Type:  

          Requested Term:    

Property Type:  

Property State:  

          Desired County: 

Estimated Property Value:  

  

Loan Requested:  

  

Available Assets:  

(e.g.: If you have $5,000.00 available for the down payment and an additional $8,000.00 for closing cost, then enter $13,000.00  

Borrower Annual  Income:  

 

Will there be a Co-Borrower:   

Yes   No            

  Co-Borrower Annual Income:

Monthly Debt Payments:  

 

 Only include minimum charge cards payments and installment debt such as  auto loans and student loans.

Grade Your Credit:  

I always pay my mortgage/rent/credit card bills on time.
I usually  pay my mortgage/rent/credit card bills on time.
 I have or had  problems which may include late payments/ judgments/ Bankruptcy.
I do not have any credit history.
 I have no idea how my credit is.

Primary Concern:  

Cash for Down Payment and Closing Cost
Income to Qualify
 Ability to Verify Income or Assets
Poor Credit History
Comments: