Purchase
Refinance | Equity Line of Credit
About Your Loan Program
Loan Program	Loan Purpose
30 Year Fixed 15 Year Fixed 5 Yr Balloon 7 Yr Balloon 1/1 ARM 3/1 ARM 5/1 ARM 7/1 ARM VA 30 Yr FHA 30 Yr FHA ARM Other/See Comments	Purchase Constr. Loan FHA Loan VA Loan Other/See Comments
Loan Amount ($) *	Property Value ($) *	Estimated Timeframe
		< 30 Days 30-60 Days 60-90 Days Not Sure 120

Property Information
Property Type
- Single family Condo Commercial Investment Co-op Mobile Home Multi Family
Address *	City *             State	Zip *
	AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY

Borrower Information
First Name *	Last Name *	Social Security Number
		- -
Daytime Phone *	Evening Phone *	Email

Employment Information
Self Employed	Years Employed	Annual Income($)
no yes	1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20

Income and Expense Information
Monthly Expenses($)	Credit History
	Excellent Good Fair Poor
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