Online Mortgage Application

Instructions on filling out this form:
This form is divided into several pages. Please fill in as much information as you can as it will assist us in determining your eligibility for a mortgage.

Do not use your web browser's BACK button to go to previous pages. Instead use the navigation buttons found at the bottom of each page. You will be able to review your complete entry before you submit it to us. Your responses are held in strict confidence.

 

Your Information (page 1 of 3)
Please fill out all of the information below as best as possible.

Name

Date of Birth

Email

Address

Day Phone

Evening Phone

County of Residence

U.S. Citizen

Yes No

Employer

Veteran

Yes No

Spouse

Spouse's Date of Birth

U.S. Citizen

Yes No

Employer

Veteran

Yes No

 

FAMILY INFORMATION

Number of Children

Have you or your spouse been married before ?

Yes No

If yes, do you or your spouse have any children under 16 from this previous marriage?

Yes No

Do you or your spouse have children who have died leaving children?

Yes No

Does anyone to whom you may be leaving part of your estate require any help or protection in managing money or other property?

Yes No

Do you and your spouse have a pre-nuptial or post-nuptial agreement?

Yes No

Financial Overview (page 2 of 3)


PROPERTY INFORMATION

I am applying for New Mortgage Refinancing
If refinancing, when was the house bought and what is the current mortage balance


Current Balance

If new mortgage, are you currently working with a realtor?

Yes No

Name

Email

Have you already found a home? Yes No
Property Type
What is the price range?
Do you have a preferred title company?

Yes No

Name

Email



INVESTMENTS AND SAVINGS

Financial Institution

 

Value

In Whose Name

  

  

 TOTAL

 

Will you or your spouse receive money as a gift for closing of this house?

Yes No


REAL ESTATE

Date

Purchase Price

Fair Market Value

In Whose Name

Do you or your spouse have an interest in any business?

Yes No


MONTHLY INCOME

 

 

You

Your Spouse

Joint

Monthly Income

Social Security

Employment

Pension from

IRAs, Annuities, etc.

Rents

Business Interest

Other

TOTALS

Which sources of income have a benefit for a surviving spouse?


LIFE INSURANCE

Whose Life

Company

Face Value

Cash Value

Policy Number

Beneficiary


RETIREMENT ASSETS

Do you have IRAs, Vested Pension Plan, Annuities or Other Assets that would pass on your death to a particular designated beneficiary?   Yes No

Description

Value

Beneficiary

Do you or your spouse expect an inheritance?

Yes No

Are you or your spouse the beneficiary of any trust?

Yes No


LIABILITIES

(mortgages, notes to banks, notes to others, loans on insurance, other)

Description

Balance Due

Monthly Payment

Maturity Date

Location of important papers:

The above will be verified by a credit pull.
 

Legal (page 3 of 3)

 

 

Date Made

Location of Original

Last Will and Testament

Durable Power of Attorney

Living Will/Health Care Proxy

Living Trust

I am serving as executor or administrator of an estate

Yes No

I am involved in a lawsuit

Yes No

I have been in bankruptcy in the last 7 years

Yes No

I have been in forclosure in the last 7 years

Yes No

Do you have an attorney

Yes No

Name

Email

Phone


To review your form before submission, please click on REVIEW SUBMISSION or if you are confident that all of your information is correct, please click on SUBMIT MY INFORMATION.

When you are ready, please click the appropriate button.