SIMPLE APPLICATION

1. Please choose the type of home loan you are shopping for below:

*
Applicant's First Name
*
Applicant's Last Name
*
Co- Applicants First Name

Co- Applicants Last Name

Current Street Address
*

City *

State *

Zip Code *

Home Phone #
* Example: 949-555-1212
Work Phone #
Example:949-555-1212
Mobile Phone / Pager #
Example:949-555-1212
Best time to contact you?
*
Email Address
*

2. Property Details

Do you currently Own or Rent ? Own Rent *

Property Type

Purchase Price of Your Home
* Example: 365000
Date Property was Acquired
Example: 9/2004
Present Value of Property $
* (Approximate Appraised Value) Example: 365000

3. Existing First Mortgage Details

If you do not have a 1st Mortgage, simply type 0 in the amount owe field then move
to question # 5.

Amount Owed on 1st $
* Example:125000
Interest Rate on 1st %
* Example:6.25

Rate Type Fixed Adjustable

Monthly Payments on 1st $
* Example:2248

4. Existing Second Mortgage Details
If you do not have a 2nd Mortgage, simply move to question # 5.

Amount Owed on 2nd $
Example:125000
Interest Rate on 2nd %
Example:7.625
Rate Type
Fixed Adjustable

Monthly Payment $
Example:1870

5. Approximate Loan Amount Needed

Loan Amount Desired $
* Example: 120000

6. Your Credit Rating:

How would you rate your credit?

Excellent Good Fair Poor *

Additional Comments:
Please type in below anything you feel might be helpful
to us in consideration of your application: