After Completion of application do one of the following:

Pre-Qualification Information: 

Did you find our site on a search engine?    Yes  No   
If yes, please specify:
Alta Vista  Excite  Hot Bot   Lycos   MSN   AOL   Google   Yahoo  Other search engine
Did you hear about us on:
Local TV                  Please type in TV station
Radio station           Please type in radio station
Newspaper              Please type in newspaper
Loan Amount:

Type of Loan:
Purchase Refinance  Second Home Income Property
Type of Financing:
Conventional Fixed  Conventional ARM  FHA VA  Second mortgage

Customer Information

Borrower: 

Co-Borrower:  

E-mail: 

Current Street Address: 

City:    State:    Zip Code: 

Home Phone:    

Work Phone: (Include extension if applicable)

Property Information

Purchase Price -- OR -- Current Value of Property if Refinance: 


Cash Down payment: (If Purchase)


Property Address: 

Property City:    

Property State:    Property Zip Code: 

Property Type:
Single Family  Condo/Townhouse  Multi Family

Will you occupy the property?:
Yes  No

If purchasing, do you have a Realtor® with whom you are working?
Yes  No

Would you like for us to find a Realtor® who specializes in your area?
Yes  No

Credit Information

How would you rate your Credit?  Excellent   Good   Fair   Poor

Borrower Employment Status:              Co-Borrower Employment Status:
Salaried/Hourly Self Employed        Salaried/Hourly  Self Employed

Borrower Employer:                            Co-Borrower Employer                     
                                
Number of years with Company:           Number of years with Company:
                                                        
Borrower Gross Monthly Income:          Co-Borrower Gross Monthly Income:
                                                 
Liquid Assets: (Include checking, savings, stocks, mutual funds etc.)
                                                 
Borrower Retirement and 401k:            Co-Borrower Retirement and 401k:
                                                 
Borrower Monthly Auto Payments:         Co-Borrower Monthly Auto Payments:
                                                 
Borrower Credit Card (Min. Mo. Pmt)    CoBorrower Credit Card (Minimum Mo. Pmt.)
                                                 
Other Monthly Debt: (Child Support, Student Loans. Do not include current house  payment, rent or utilities)

If refinancing, enter outstanding balance owed:

What is your Current Interest Rate?:

Type of Current Loan:
Conventional   FHA  VA   Other
Current Monthly Payment (excluding taxes):

Annual Property Taxes:

Do you currently have Mortgage Insurance?:
Yes No
Do you have a Second Mortgage or a line of credit on the Subject Property?:
Yes No
Do you want to keep this loan or consolidate it with the first mortgage? 
Keep  Consolidate

Any additional information?  Tell us what you'd like to do.  Type in box below: