Please note that the fields marked with an asterisk (*) are required.
Contact Information  
*Full Name:
*Email Address:
*Best Contact Number:
Your Home Purchase  
What type of property are you buying?
What kind of occupancy is the property going to be used for?
What price range are you looking in?
What is your goal for a monthly mortgage payment, not including taxes or insurance?
What amount do you wish to put as a down payment?
Will you be getting a gift for any part of the down payment?
What is your desired loan type
Do you want an interest only option on your loan?

 If you are putting less than 20% down, what type of second trust deed do you want?
Real Estate Agent You Are Working With:
Your Personal Information  
OK to run credit:
Credit FICO score last time checked:
Birth Date:
*Present Address:
Number of Years at Present Address:
( If less than 2 years provide previous address )
Previous Address:
Number of Years at Previous Address:
Currently, do you rent or own?

What is your monthly rent or mortgage?
Employment Information  
Name of employer / company:
Years at Job:
Position/ Title/ Type of Business:
Work Phone number:
Work Address:
Financial Information  
Are you self employed?

If income has been declining the last 3 years, please explain:

Monthly Debt
(Auto, Credit Card, Student Loans, Alimony/Child Support):

Checking/ Savings ( balance):
401k / IRA:
Stocks & Bonds (Outside 401k / IRA):
Do you own another property? YesNo
Do you have a co-borrower?