Borrowers Information:
BORROWERS Full Name:
Date of Birth: (MM/DD/YYYY)
Social Security No.#: (xxx-xx-xxx)
Home Address: (Apartment or Unit No. [if any])
City, State & Zip Code:
Home No. #: (Include Area Code)
Personal Email:
EMPLOYERS Name:
Address: (City, State & Zip)
Work No. #:
Gross Monthly Income: (Before Taxes)
Position or Title:
Years on This Job:	Years on Job 1-Year 2-Years 3-Years 4-Years 5-Years 6-Years 7-Years 8-Years 9-Years 10-Years 11-Years 12-Years 13-Years 14-Years 15-Years 16-Years 17-Years 18-Years 19-Years 20-Years 21-Years 22-Years 23-Years 24-Years 25-Years+
Months on This Job:	Months on Job 1-Month 2-Months 3-Months 4-Months 5-Months 6-Months 7-Months 8-Months 9-Months 10-Months 11-Months
Borrowers Credit:	Credit History Excellent - 720 to 800 + Good - 680 to 720 Fair - 620 to 680 Bad - 400 to 620 Unknown
Married / Single:	Marital Status Married Single Widowed Co-Habitating
Co-Borrowers Information: (Complete if their is a Coborrower)
CO-BORROWERS Full Name:
Date of Birth: (MM/DD/YYYY)
Social Security No. #: (xxx-xx-xxx)
Personal Email:
EMPLOYERS Name:
Street Address: (City, State & Zip)
Work No. #: (Include Area Code)
Gross Monthly Income: (Before Taxes)
Position or Title:
Years on This Job:	Years on Job 1-Year 2-Years 3-Years 4-Years 5-Years 6-Years 7-Years 8-Years 9-Years 10-Years 11-Years 12-Years 13-Years 14-Years 15-Years 16-Years 17-Years 18-Years 19-Years 20-Years 21-Years 22-Years 23-Years 24-Years 25-Years+
Months on This Job:	Months on Job 1-Months 2-Months 3-Months 4-Months 5-Months 6-Months 7-Months 8-Months 9-Months 10-Months 11-Months
Co-Borrowers Credit:	Credit History Excellent - 720 to 800 + Good - 680 to 720 Fair - 620 to 680 Bad - 400 to 620 Unknown
Asset Information:
401K / IRA Acct's: (Combined Amounts)
Stocks & Bonds Accounts: (Combined Amounts)
Checking / Savings Acct's: (Combined Amounts)
Debt Information:
Monthly Rent or Mortgage Amount:
Monthly Car Payment: (Combine for all Borrowers)
Monthly Credit Card Debt: (Combine for all Borrowers)
Monthly Support: (Alimony & Child Support) Receiving (+) Paying (-)
Property Information:
PROPERTY ADDRESS:
City, State & Zip: (If Purchasing - TBD -To Be Determined)
Loan Information:
Loan Amount?
Type of Loan?	Loan Type Desired Conventional 10% Down FHA 3.5% Down VA 0% Down Other
Loan Term:  (In Years: 30-Year Fixed)	Loan Term / Time 30-Year Fixed 20-Year Fixed 15-Year Fixed 2-Year Adjustable Other Unknown
Property Status: (What will the Property Status Be)?	Owner or Non-Owner Owner Occupied Non-Owner Occupied
Est. Close of Escrow Date:	Immediately 1 - Month 3 - Months 6 - Months 1 - Year More than a Year Close of Escrow Date
Purchase or Refinance:	Purchase Refinance Cash-Out Refinance No Cash-Out Refinance Home Equity Line of Credit Purchase or Refinance
Purchasers Only: (Skip if you are Refinancing)
Do You Have Down Pmt Funds:  (if any)	Down Payment Funds Yes No
Down Pmt Amt:  (if any)	Amt of Down Payment 0% - Down Payment 3% - Down Payment 5% - Down Payment 10% - Down Payment 15% - Down Payment 20% - Down Payment 20% Plus Unknown
Refinancing Only:
Equity Cash Out:	Cash Out Amount 10,000 15,000 25,000 30,000 35,000 40,000 45,000 50,000 55,000 60,000 65,000 70,000 75,000 80,000 85,000 90,000 95,000 100,000 Over 100,000
Home Improvements:	Yes or No Yes = Need Home Improvements No = Home Improvements Needed
Final Questions and Suggestion Box:
State where you reside:	State You Live In Alaska Alabama Arkansas CALIFORNIA Colorado Connecticut Dist. of Columbia Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisina Maine Maryland Massachusetts Michigan Minnesota Missippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Rhode Island Pennsylvania South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington D.C. Washington State West Virginia Wisconsin Wyoming
Additional Information: (Please tell us anything else you feel is important for us to know)