Application Please note that all fields followed by an asterisk must be filled in. Property State*
---Select--- • Florida
• New Jersey
County of subject property*
How did you hear about us* If Realtor - Realtor's Name
Purchase or Refinance*
---Select--- I need a Pre-Approval Letter
Purchase with No Sales Contract
Purchase with Sales Contract
Refinance
Other
When do you want to close*
---Select--- ASAP
30 days
more than 30 days
Describe your Credit*
---Select--- Excellent (720 and above)
Good (680-719)
Average (620-679)
Fair (580-619)
Poor (579 and below)
Property type*
---Select--- Single family house
Two family
3-4 family
Manufactured home
Cooperative
Condominium
Other
Occupancy*
---Select--- Primary residence
Second home
Investment property
Other
Loan type*
---Select--- FHA
VA
Conventional
USDA
Other
Have you ever declared bankruptcy, when was it discharged*
---Select--- Never Declared
1-12 months ago
13-24 months ago
25-36 months ago
37-48 months ago
49-60 months ago
61-72 months ago
Over 72 months ago
Do you have any foreclosures*
---Select--- Never Foreclosed
1-12 months ago
13-24 months ago
25-36 months ago
37-48 months ago
49-60 months ago
61-72 months ago
73-84 months ago
Over 84 months ago
Have you ever had a short sale*
---Select--- Never short sale
1-12 months ago
13-24 months ago
25-36 months ago
37-48 months ago
49-60 months ago
61-72 months ago
73-84 months ago
Over 84 months ago
Do you have any collection accounts, excludung medical*
---Select--- None
Less $1,000.00
More than $1,000.00
More than $5,000.00
More than $10,000.00
Don't know
Verifiable rental or mortgage history*
---Select--- Mortgage payment paid on time
12 months cancelled rent checks
Yes - Management company
Mortgage or rent payments late
I cannot verify rental history
Property value*
Loan Amount*
Your first name*
Your middle initial
Your last name*
Please choose a suffix
---Select--- Sr.
Jr.
I
II
III
Daytime/Work Phone*
Evening Phone*
Cell Phone*
What is your employment status *
---Select--- Full Time
Part Time
Self Employed
Home Maker
Student
Retired
Other
What is your email address*
Current mailing address*
City*
State*
ZIP code*
How long have you lived at this address*
---Select--- Less than 2 years
More than 2 years
Date of birth*
Citizenship status*
---Select--- US Citizen
Permanent Resident Alien
Non-Permanent Resident Alien
Non-Resident Alien
Social Security #*
Marital status*
---Select--- Married
Not Married
Divorced
Separated
Are you requesting a loan with a spouse or Co-borrower*
---Select--- No co-borrower
Spouse
Other co-borrower
If Co-borrower, Co-borrower first name
Co-borrower last name
Co-borrower current mailing address
City
State
Zip code
Co-borrower date of birth
Co-borrower Social Security #
What are your total monthly debt payments, excluding housing*
What is your monthly housing payment*
Annual Income*
stocks, bonds, mutual funds, 401K checking and savings*
How much do you have in stocks, bonds, mutual funds, 401K*
Please tell us about any special circumstances that may apply to your loan request and/or the best time for us to call you
