This is the Application Disclaimer.
1003 SHORT MORTGAGE APPLICATION
1. Let's Get Acquainted
First Name * Last Name *
Telephone (Hse) * Telephone (Bus)
Email * Fax
Loan Consultant
2. Type of Mortgage and Terms of Loan
Mortgage Applied for:
Loan Amount:
Interest Rate:
 %
No. of Months:
360 Months = 30 Yrs.
180 Months = 15 Yrs.
120 Months = 10 Yrs.
84 Months = 7 Yrs.
Amortization Type:
3. Property Information and Purpose of Loan
Subject Property Address:
City:
State:
ZIP Code:
Purpose of Loan:
Property Will Be:
Purchase Price or Estimated Value:
Source of Down Payment, Settlement Charges, and/or Subordinate Financing:
Estate Will Be Held in:
Complete the items below if this is a construction, construction-permanent, or refinance loan:
Existing Liens: (Amount)
Purpose of Refinance:
4a. Borrower Information Same as Applicant
First Name: *
Last Name: *
Social Security Number:
Evening Phone:
Marital Status:
Number of Dependents:
(Count shared dependents once)
Date of Birth:(MM/DD/YYYY) *
Email Address: *
Present Address
Street:
City:
State:
ZIP Code:
Rent or Own?
How Long at Address:  years    months
4b. Co-borrower Information
First Name:
Last Name:
Social Security Number:
Evening Phone:
Marital Status:
Number of Dependents:
(Count shared dependents once)
Date of Birth:(MM/DD/YYYY)
Present Address ( Same as Borrower )
Street:
City:
State:
ZIP Code:
Rent or Own?
How Long at Address:  years   months
5. Employment Information
Current Employer
Borrower Co-borrower
Employer Name:
Employer Address:
City, State & Zip

,
Self-employed: 
Time on Job:
  years  
Employer Name:
Employer Address:
City, State & Zip

,
Self-employed: 
Time on Job:
  years  
6. Monthly Income and Combined Housing Expense Information
GROSS MONTHLY INCOME BORROWER CO-BORROWER
Base Empl. Income:
Overtime
Bonusus
Commisssions
Dividends/Interest:

Describe Other Income: Notice: Alimony, child support, or separate maintenance need not be revealed if you do not choose to have it considered for repayment of this loan.
  Owner Description Monthly Amount
#1 BORROWER
#2 BORROWER
#3 BORROWER
#4 CO-BORROWER
#5 CO-BORROWER
#6 CO-BORROWER
     
Combined Monthly Housing Expense Where You Live Now Proposed Loan
Rent:  
First Mortgage (P&I):
Other Financing (P&I):  
Hazard Insurance:
Real Estate Taxes:
Mortgage Insurance:
Homeowner Assn. Dues:

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