Mortgage Application (Form 1003)

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Type of Loan:

Purchase

Refinance

Home Description:

Single Family

Multi-Family

Condominium

Townhouse

Your Credit Profile:

Excellent (720 and above)

Good (660 – 719)

Average (620 – 659)

Below Average (580 – 619)

Poor (579 and below)

Property Use:*

Primary Residence

Secondary Home

Investment Property

Property Location:*

Purchase Year:*

Property Location:*

Purchase price of the new home:*

Estimated Down Payment:*

Desired Type of Rate:*

Fixed

Adjustable

Estimated Home Value:*

1st Mortgage Balance:*

1st Mortgage Interest Rate:*

1st Mortgage With:*

I don't have a mortgage

Bank of America

Chase

Citibank

Quicken Loans

Wells Fargo

Other

Existing Type of Rate:*

Fixed

Adjustable

Do you have a 2nd mortgage?:*

Yes

No

How much additional cash do you wish to borrow?:*

How old are you?:*

Can we interest you in a reverse mortgage?:*

Yes

No

Have you ever refinanced before?:*

Yes, I have refinanced before

No, I was too busy

No, I had a bad experience

No, I could not see the financial benefit

No, I did not think I would qualify

Employment status:*

Employed

Retired

Number of late mortgage payments in the past 12 months?:*

None

1

2+

Any bankruptcy in the past 7 years?:*

Yes

No

Do you currently have an FHA loan?:*

Yes

No

I don't know

Any foreclosure in the past 3 years?:*

Yes

No

Income Amount (Monthly Income):*

Can you show proof of your income?:*

Yes

No

Current Mailing Address Street:*

Property Location:*

Email Address:*

Cash-Out Amount:*

Active or previous U.S. military service?:*

Yes

No

Would you like to be contacted by a real estate agent in your area?:*

Yes

No

Are you or your spouse currently in a VA loan?:*

Yes

No

Current Mailing Address Street:*

First Name:*

Last Name:*

Property Location:*

Phone Number:*

Date of Birth:*

Social Security Number:*

I agree to the following terms & conditions
I hereby certify that the information given in my submission is complete and correct and is given for the purpose of potentially obtaining a mortgage loan and/or financial services applied for.

Mortgage Application (Form 1003)

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