Borrower 2Co-Borrower         Name:   Name:   Soc Sec #:     Birth Day: Soc Sec #:     Birth Day: Email:   Email:      Home Work Cell    Home Work Cell Phone:   Phone:   What's the Game Plan?     Are you looking for a:     Purchase Loan Refinance Home Equity Loan 2nd Trust Deed   Price/Value of home: $ Est. Loan Amount:  $      Down Payment%:  20% 3% 5% 10% 15% 25% 30%+ 0% N/A   or   $ Source of Down Pmt.:     Checking / Savings Sale of Current Home Gift From a Family Member Sale of Securities/Stock Other N/A (Refinance)   If "Other", then: Subject Prop Address:     City:   State:   Zip: How did you find me?:     Realtor Referral Friends Referral Internet Saw your Flyer Past Clients Referral Other Let me know who: Residence Information ( for past 2 years ) Street Address City State Zip Code Own/Rent Term (Yrs/Mos.) Pres. Address:   Own Rent  Prev. Address:   Own Rent Employment Information   Borrower's Employ.:    Your Title: Address:   City: State:   Zip:   Self-Employed?:   No Yes   Time on Job: Yrs: Mos.:   Yrs. in Prof.:            Co-Borrower's Employ.:    Your Title: Address:   City: State:   Zip:   Self-Employed?:   No Yes   Time on Job: Yrs: Mos.:   Yrs. in Prof.:         Previous Employment Information - (for at least 2 years)    Previous Employer   Monthly Income Dates:  From To Borrower: $  Co-Borrower: $ Current Monthly Income Information     Salary (Gross) Overtime Bonus/Commission Other Income Borrower:   $ $ $ $ Co-Borrower:   $ $ $ $   Assets  - (Checking, Savings, CD's, Mutual's, IRA's, 401(k)'s, Etc.)   Institution Account Type Account Number Current Balance   Checking C.D. IRA Money Mkt. Mutual Fund Other Retirement Savings Stocks 401(k) $   Savings Checking C.D. IRA Money Mkt. Mutual Fund Other Retirement Stocks 401(k) $   Money Mkt. Checking C.D. IRA Mutual Fund Other Retirement Savings Stocks 401(k) $   401(k) Checking C.D. IRA Money Mkt. Mutual Fund Other Retirement Savings Stocks $   Other Checking C.D. IRA Money Mkt. Mutual Fund Retirement Savings Stocks 401(k) $   Automobiles, Trucks, Motorcycles, Boats, Etc.   Year & Model Current Value Year & Model Current Value   $ $   $ $ Do You Own Rental Property?    Property Address City Prop. Value Rental Inc. Mtg. Amt. Mtg. Pmt. Mo. Expenses   $ $ $ $ $   $ $ $ $ $ Liabilities   Current Monthly Housing Expenses for your Primary Residence:   Rent $ or Mtg. Pmt: $   Prop. Tax: $    HOA Dues: $   Current Credit Card Debt:   Total Balance on Credit Cards: $   Minimum Monthly Pmt.: $ All Other Monthly Liabilities   Institution Type of Liability Balance Owed Min. Mo. Pmt.   Mortgage Auto Loan Student Loan Other Debt Child Support Alimony $ $   Auto Loan Mortgage Student Loan Other Debt Child Support Alimony $ $   Auto Loan Mortgage Student Loan Other Debt Child Support Alimony $ $   Student Loan Auto Loan Mortgage Other Debt Child Support Alimony $ $   Other Debt Auto Loan Mortgage Student Loan Child Support Alimony $ $ Comments