Borrower Information Co-Borrower Information
Loan Officer:  Check here if Co-Borrower on Loan
 
* First Name *
Middle Name
Last Name * Last Name *
Suffix Suffix
Home Phone * Home Phone *
Work Phone Work Phone
Cell Phone Cell Phone
* *
* E-Mail *
Date of Birth - - * Date of Birth - - *
Age * Age *
Own/Rent * Own/Rent *
US Citizen? * US Citizen? *
Borrower Current Address Information Co-Borrower Current Address Information
Address * Address *
City * City *
State * State *
Zipcode * Zipcode *
Current Payment * Current Payment *
Time at this address * Time at this address *
  *   *
Previous address (if current is less than 2 yrs) Previous address (if current is less than 2 yrs)
Address Address
City City
State State
Zipcode Zipcode
Previous Payment Previous Payment
Time at this address Time at this address
   
Borrower Employment Information Co-Borrower Employment Information
Employer * Employer *
Address * Address *
City * City *
State * State *
Zipcode * Zipcode *
Position * Position *
Job Length Years * Job Length Years *
Job Length Months * Job Length Months *
Years in Same Field * Years in Same Field *
Monthly Income * Monthly Income *
If at job less than two years, complete below If at job less than two years, complete below
Employer Employer
Address Address
City City
State State
Zipcode Zipcode
Position Position
Job Length From: Job Length From:
Job Length To: Job Length To:
Previous Monthly Income Previous Monthly Income
Checking and Savings Accounts Refinance Questionnaire
Financial Institution Amount $ Original Purchase Price
Purchase Date
Original Loan Amount
Stocks and Bonds Property Address
Stock/Bond Amount $ City
State/Zip
Current Loan Amount
Current Interest Rate
Other Assets Current Term
Other Asset Amount $
Have a Second Lien ,
Approx. Value of Home
Approx. Taxes
    Approx. Homeowners Ins.
      Mortgage Insurance
      Prepayment Pentalty
      How long do you plan on living in this home?
Additional Information
* *
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