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Borrower Information Co-Borrower Information
   
First Name
Last Name Last Name
Home Phone Home Phone
Work Phone Work Phone
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E-Mail
Date of Birth - -
(Month-Day-Year)
Date of Birth - -
(Month-Day-Year)
Address Line 1 Address Line 1
City City
State Zip State Zip
Borrower Employment Information Co-Borrower Employment Information
Employer Employer
Address Address
City City
State Zip State Zip
Position Position
Job Length Years Job Length Years
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 Zip State Zip
Position Position
Job Length Years Job Length Years
Years in Same Field Years in Same Field
Previous Monthly Income $ Previous Monthly Income $

Checking and Savings Accounts Refinance Questionnaire
Financial Institution Amount $ Original Purchase Price
Financial Institution Amount $ Purchase Date
Stocks and Bonds Original Loan Amount
Stock/Bond Amount $ Property Address
Stock/Bond Amount $ City
Stock/Bond Amount $ State Zip
Other Assets Current Loan Amount
Other Asset Amount $ Current Interest Rate
Other Asset Amount $ Current Term years
Other Asset Amount $ Have a Second Lien , Amount $

      Approx. Value of Home $
      Approx. Taxes $ per year
      Approx. Homeowners Ins. $ per year
      Mortgage Insurance
      Prepayment Penalty
      How long do you plan on living in this home? years

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