Our short
form is an easy and fast way to request mortgage information. Please
complete the following
Borrower Personal Information
*
First Name:
*
Last Name:
*
Email:
Referral Name:
Home Phone:
(example format: (502) 643-2301
Cell Phone:
Work Phone:
Ext.
Marital Status:
Are you a U.S. citizen?
Date of Birth:
(mm/dd/yyyy)
# of Dependents:
Dependent Age(s):
Separate ages by commas.
Your Current Address
Street Address:
City:
Zip:
Years at this Address:
Years
Months
Rent or Own:
Subject Property
Purpose of Loan:
Property Usage:
Loan Amount:
$
Purchase:
$
Number of Units:
Year Built:
Property Address:
City:
Zip
:
Monthly Income
Submitting income from alimony, child support, or separate maintenance income is optional if you do not want to use that income for qualification purposes.
Base Income:
$
Bonuses:
$
Commission:
$
Other Income:
$
Assets
Checking:
$
Savings:
$
Retirement Funds:
$
Mutual Funds:
$
Other:
$
Do you have a co-borrower?
Yes
No
Co-Borrower Personal Information
*
First Name:
*
Last Name:
*
Email:
Home Phone:
(example format: (502) 643-2301)
Cell Phone:
Work Phone:
Ext.
Marital Status:
Are you a U.S. citizen?
Date of Birth:
(mm/dd/yyyy)
# of Dependents:
Dependent Age(s):
Separate ages by commas.
Co-Borrower Current Address
Street Address:
City:
Zip:
Years at this Address:
Years
Months
Rent or Own:
Co-Borrower Monthly Income
Submitting income from alimony, child support, or separate maintenance income is optional if you do not want to use that income for qualification purposes.
Base Income:
$
Bonuses:
$
Commission:
$
Other Income:
$
Co-Borrower Assets
Checking:
$
Savings:
$
Retirement Funds:
$
Mutual Funds:
$
Other:
$
*
Privacy Policy:
We
take
our clients' financial privacy very
seriously. During the course of processing
your application, we accumulate non-public
personal financial information from you and
from other sources about your income, your
assets, and your credit history in order to
allow a lender to make an informed decision
about granting you credit. We restrict
access to nonpublic personal information
about you to those employees who need to
know that information to provide products or
services to you. We maintain physical,
electronic, and procedural safeguards that
comply with federal regulations to guard
your nonpublic personal information.
We collect nonpublic information about you
from the following sources: (i) information
we receive from you on applications or other
forms; (ii) information about your
transactions with us, our affiliates, or
others; and (iii) information we receive
from a consumer reporting agency.
We do not disclose any nonpublic information
about our customers or former customers to
any third party, except as permitted by law.
