Borrower:       ss#

Co Borrower     ss#

Own/Rent Own Rent   

Do You Owe More than your home is worth? I have equity in my house I owe more than my house is worth

Address 

City        State Zip

Phone:    Cell:

Email:    

Purpose of loan Purchase Refinance Are you working with a realtor?  yes No  

Rate your credit Excellent above 800 Excellent above 750 Good 700 range Fair high 600 range Poor Poor with mortgage lates Poor with collections and mortgage lates low 500's Very Poor below 500

Your Current Interest Rate  4.25% 4.5% 4.75% 5% 5.25% 5.50% 5.75% 6% 6.25% 6.50% 6.75% 7% 7.25% 7.5% 7.75% 8% Above 8% Use closest match

Your Current Mortgage            Below $50,000 $50,000 - $100,000 $100,000 - $150,000 $150,000 - $200,000 $200,000-$300,000 $300,000 - $400,000 $400,000 - $500,000 $500,000 - $700,000 $700,000 - $1,000,000 $1,000,000 -$2,000,000 $2,000,000 $4,000,000 $4,000,000 and above

Value of your home/purchase Below $50,000 $50,000 - $100,000 $100,000 - $150,000 $150,000 - $200,000 $200,000-$300,000 $300,000 - $400,000 $400,000 - $500,000 $500,000 - $700,000 $700,000 - $1,000,000 $1,000,000 -$2,000,000 $2,000,000 $4,000,000 $4,000,000 and above

Current Mortgage Type 30 year fixed 20 year fixed 15 year fixed Option Arm Negative Amortization Home Equity Line Balloon Variable Rate Mortgage Payment about to go up 2/28 loan

How Much do you have for a Down Payment 40% 30% 20% 10% 5% Need Down Payment assistance

Income Range + $300,000 $200,000-$300,000 $150,000-$200,000 $100,000-$150,000 $75,000-$100,000 $60,000-$75,000 $50,000-$60,000 $40,000-$50,000 $30,000-$40,000 Below $30,000

How did you hear about us? Internet Search Engine Business Card Realtor Referral Referral other Mailer to you Newspaper ad

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