Loan Application

Please fill out this simple loan application, and one of our friendly loan officers will contact you via e-mail or phone (whichever you prefer) within 24 hours.

I. TYPE OF MORTGAGE AND TERMS OF LOAN

Mortgage Applied For:    Conventional        Other
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Value/Purchase Price of House
Amount of Loan:   Amount Towards Closing:
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Mortgage Type:

II. PROPERTY INFORMATION AND PURPOSE OF LOAN

Subject Property Address: (street, city, ZIP)
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Purpose of Loan:     Purchase        Construction       Other
                                   Refinance     Debt Consolidation
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Property will be:     Primary Residence      Secondary Residence     Investment

III. BORROWERS INFORMATION

Borrower	Co-Borrower
Borrower's Name: _________________________________ Home Phone: Work Phone: E-mail: _________________________________ Married Single Separated Social Security Number _________________________________ Present Address: (street, city, ZIP) Rent Own No Yrs	Co-Borrower's Name: _________________________________ Home Phone: Work Phone: E-mail: _________________________________ Married Single Separated Social Security Number _________________________________ Present Address: (street, city, ZIP) Rent Own No Yrs

IV. EMPLOYMENT INFORMATION

Borrower	Co-Borrower
Name of Employer: Self Employed Yrs on Job Monthly Income	Name of Employer: Self Employed Yrs on Job Monthly Income

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How did you hear about our web site?
If other please specify:
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Thank You for your time.
How would you like us to contact you?

		Home phone
		Work phone
		E-mail
		Postal mail