Client Information

Loan Application

*Client Information*
Loan Officer or Processor you are working with:
How did you find out about our site?

Best time to contact you?
Best number to contact you? Home Work Cell	(111) 111-1111
Is this loan a: Purchase Refinance Home Equity/Debt Consolidation

*Borrower Information*
First Name:
Middle Initial:
Last Name:
Suffix:
Social Security Number:	111-11-1111
Home Phone:	(111) 111-1111
Date of Birth:	mm/dd/yyyy
Self-Employed:
Current Employer:
Years at Current Employer:
Current Position:
Work Phone:	(111) 111-1111
Email Address:
Previous Employer (if < 2 yrs at current employer):
Years at Previous Employer:
Previous Position:
Previous Employer Work Phone:	(111) 111-1111

*Additional Information:*
Have you had an ownership interest in a property in the last 3 years?
Type of Property Owned:
Title Held as:
Do You Intend to Occupy the Property as Your Primary Residence:
Present Address:
City:
State:
Zip code:
Years at present address:
Presently:
Previous street address if less than 2 years at current address:
Previous City:
Previous State:
Previous Zip:
Years at Previous Address:

*Co-Borrower Information*
First Name:
Middle Initial:
Last Name:
Suffix:
Social Security Number:	111-11-1111
Home Phone:	(111) 111-1111
Date of Birth:	mm/dd/yyyy
Self-Employed:
Current Employer:
Years at Current Employer:
Current Position:
Work Phone:	(111) 111-1111
Email Address:
Previous Employer (if < 2 yrs at current employer):
Years at Previous Employer:
Previous Position:
Previous Employer Work Phone:	(111) 111-1111

*Additional Co-Borrower Information*
Have you had an ownership interest in a property in the last 3 years?
Type of property owned:
Title held:
Do you intend to occupy the property as your primary residence?
Present address:
City:
State:
Zip code:
Years at present address:
Presently:
Previous Address (if < 2 yrs at current address):
Previous City:
Previous State:
Previous Zip:
Years at Previous Address:

*Income\|Asset\|Liabilities*	*Borrower*	*Co-Borrower*
Salary and self employment income (Gross/Monthly):	$	$
All Other Income (Monthly):	$	$
Vested Interest In Retirement Fund:	$	$
Checking Account:	$	$
Savings Account:	$	$
Proceeds from sale of real estate:	$	$
Total Non Housing Payments (Credit Card, Installment Loans):	$	$
Total Current Housing Expense (Mortgage Payment/Rent):	$	$
Taxes/Insurance (Monthly)	$	$
If Refinance What is Payoff on Current Mortgage?	$

*Subject Property Information*
Street Address:
City:
State:
Zip Code
Number of Units:
Year Built:	(Optional)
Year Acquired (if refinance):
Sales Price:
Estimated Value (if refinance):
Will this property be owner occupied?
The following information only applies to new Condo or PUD Projects:
No. units in Project:
Is PUD or Condo project 50% Sold?
What do you hope to accomplish with this mortgage?
The information in this application is true and may be relied on in evaluating your loan request.