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Please fill out as much information as possible. Fields marked with anĀ asterisk * are required.

Full Name

Email Address

Phone #

Street Address:



Loan Type:

Property Type:

Is this your primary residence?

Current Properties Owned:

Current Mortgages on other properties?

Rent Payments Collected Monthly:

Rental Properties Being Rented?

Are payments made by check, cash or other means of payment? (For Bank Use Only - Not for IRS purposes or for any reason to disclose your private information)

Current Loan Type:

Current Loan Interest Rate:
(For example - 5.875%, 5.625%, 5.5%, 5.375%, 5.25%, 5.125%, 5.00%, 4.875%, etc)

Fixed for the first:

Monthly Payment? (Including principal, interest, taxes & insurance monthly AKA (PITI) Mortgage Payment + Property Taxes + HOI + (Home Owners Association Dues)-AKA HOA which only usually applies to TownHouses, Condo's & Coop's) payments additional for living in a gated community that may or may not be paid through the mortgage every month.

Current Annual Property Taxes: (Including General, City, School, Water, Electric, etc)

Do you currently pay any Private Mortgage Insurance?

Homeowner's Insurance Annual Premium:

Most FHA mortgages have PMI insurance: What is the payment?

Desired Loan Amount:

Borrower(s) on or to be on Mortgage: (If a co-borrower exists, please separate names with a comma)

Employment information: (Check all that apply)
 W-2 Employment Self-Employment Fixed Income Social Security Income Social Security Disability Pension Income Alimony Income State Income for Children (for single parents)

Questions or Comments:

Federal or other Legally Notarized Proof:
Please call us for any and all questions & inquires pertaining to all other Income that might be considered a unique or uncommon form of valid & consistent factors which so many unqualified or uninformed banks, Loan officers, Mortgage consultants, Bank Representative, Mortgage Broker, Loan experts tend to overlook. These factors may assist you in the loan qualification process. Unemployment Income cannot be used as Income with any banks.

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