Basic Loan Application / Information

Please provide some basic information by completing the form below. We will review your data and contact you with specific rate & program information. Please note that for security reasons this document does not request a social security number.

Borrower Information:
Name:
Address:
City:			County:
State:			Zip:
E-Mail:
Phone:	Daytime:
	Evening:
Co-Borrower Information:
Name:
Address:
City:			County:
State:			Zip:
Property Information:
Address:
City:			County:
State:	FLORIDA / NORTH CAROLINA		Zip:
Type of Property:	Single Family Condo Townhome 2-4 unit 5+ units		Occupancy:	Primary Residence Second Home Investment
Type of Loan:	Conforming Jumbo FHA/VA Investor Commercial		Purchse Price/Value:
Loan Information:
Features:	Full Doc No Income Verification No Asset Verification No Doc		Employment:	Salaried/Hourly Self Employed Retired Unemployed
Amount of Loan:			Verifiable Monthly Income:
Purpose of Loan:	Purchase Refinance/No Cash Out Refinance/Cash Out Equity/2nd		Total Monthly Liabilities:

I Prefer to be contacted by: Daytime Phone Evening Phone E-Mail Fax Fax Number (if applicable)

Enter any additional comments that may affect your mortgage loan.