BrokerMortgages.com - Full Application

STEP 1 of 4

GENERAL INFORMATION:

BORROWER

Borrower's Full Name

Home Phone	Birth Date	Yrs. School

Married Unmarried
Separated

Dependents
# ages

Present Address Own Rent # of years

Previous Address Own Rent # of years
(if less than two years)

CO-BORROWER

Co-Borrower's Full Name

Home Phone	Birth Date	Yrs. School

Married Unmarried
Separated

Dependents
# ages

Present Address Own Rent # of years

Previous Address Own Rent # of years
(if less than two years)

Social Security Number (if you want us to pull credit):
Borrower:		Co-Borrower:

Subject Address (if known):

Occupancy :

Property Type (if known):

What type of mortgage would you like?
	Purchase
	Refinance
	2nd Mortgage
	Home Equity Line of Credit
	Construction to Permanent

Purpose of Loan:
Amount Requested:

STEP 2 of 4

EMPLOYMENT:

BORROWER

Name & Address of Employer Self Employed	Yrs. on this job
Name & Address of Employer Self Employed	Yrs. employed in this line of work/profession
Position/Title/Type of Business	Business Phone

CO-BORROWER

Name & Address of Employer Self Employed	Yrs. on this job
Name & Address of Employer Self Employed	Yrs. employed in this line of work/profession
Position/Title/Type of Business	Business Phone

If employed in current position for less than two years or if currently employed in more than one position, complete the following:

Name & Address of Employer Self Employed	Dates (from-to)
Name & Address of Employer Self Employed	Monthly Income $
Position/Title/Type of Business	Business Phone

Name & Address of Employer Self Employed	Dates (from-to)
Name & Address of Employer Self Employed	Monthly Income $
Position/Title/Type of Business	Business Phone

Credit History:
Borrower:		Co-Borrower:

Credit Score? Please enter your credit score, IF KNOWN. (sometimes referred to as a fico score)
Borrower:		Co-Borrower:

Other Income: (2nd job, child support...)

E-Mail Address:
Best time to contact:

STEP 3 of 4

SUBJECT PROPERTY INFORMATION:

Year Purchased: (if refinance)
Approx Market Value or Purchase Price:
Year Occupied:
Original Cost: (if refinance)
Amount of Existing Liens: (if refinance)

MONTHLY INCOME FROM:

Primary/Employment:		Co-Borrower:
Commissions:		Co-Borrower:
Dividends/Interest:		Co-Borrower:
Other:		Co-Borrower:

Existing Loan Information: If Refinance

Mortgage Balances	Amount:	Held by:	Payment:
First:
Second:
Other:

Annual property tax, if known
Annual homeowners insurance, if known

Check here if your mortgage payment now includes property tax.
Check here if your mortgage payment now includes homeowners insurance.

If a Cash Out/Debt Consolidation Refinance:

Creditors	Amount Owed	Monthly Payment	Will you pay this off?
	$	$	Yes No
	$	$	Yes No
	$	$	Yes No
	$	$	Yes No

STEP 4 of 4

ASSETS:

Do you currently own more than one property? If yes, fill out property info below.

Property
Address

Occupancy

Property
Type

Estimated
Market
Value

Amount of
Mortgages
Liens

Gross
Rental
Income

Mortgage
Payments

Payment Includes:

Tax

Ins.

I currently own more than 6 properties Yes No If yes, how many

Liquid Assets
Checking/Savings Account:	$	Co-Borrower	$
Stocks/Bonds:	$	Co-Borrower	$
Retirement Account:	$	Co-Borrower	$
Life Insurance:	$	Co-Borrower	$
Net Cash Value:	$	Co-Borrower	$
Net Worth of Business:	$	Co-Borrower	$

Other Monthly Debts/Title Liens & Information (please describe)

Desired Terms

Comments, Hopes, Aspirations & Concerns
(use this space to add any other info you feel we need to know)

Program Reference Number (if any)

I authorize a credit check.