MORTGAGE LOAN APPLICATION
General Section
Contact Information
Name :
Home Phone :
Work Phone :
E-mail :
Best time to be reached :
Propert Location
City :
State :
Personal Information
Annual Household Income is $ :
My Credit History Is : Excellent
Good, But Some payments late in 200_
Some Credit Problems as collections in 200_
Major Credit Problems as judgment bankruptcy or foreclosure
Don't Know

Loan Amount
Loan amount desired is $
Type of Loan : 30 yr fixed
15 yr fixed
Adjustable
Commercial
I do not know
Other , Please State

Second Mortage Section
Type of loan : Credit Line
Fixed 2nd Mortgage
Other, Please State
Existing loans on property      
First Loan $
Second Loan $
Do any of the loans have negative amortization?
  : Yes
    No
    Don't Know
Reason for loan : Home Improvement
    Pay Off Bills
    Other, Please Specify