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About Your Loan Program
Loan Program	Loan Purpose
30 Year Fixed 15 Year Fixed 5 Yr Balloon 7 Yr Balloon 1/1 ARM 3/1 ARM 5/1 ARM VA 30 Yr FHA 30 Yr FHA ARM	PurchaseRefinanceConstr. LoanSee Comments/OtherFHA LoanVA Loan
Loan Amount ($)	Property Value ($)	Estimated Timeframe
		< 30 Days 30-60 Days 60-90 Days Not Sure 120

Property Information
Property Type
- Single family Condo Commercial Investment Co-op Mobile Home Multi Family
Address	Zip

Borrower Information
First Name	Last Name
Work Phone	Home Phone	Email

Employment Information
Self Employed	Years Employed	Annual Income($)
no yes	1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20	< $20,000 $20,000-25,000 $25,000-30,000 $30,000-35,000 $35,000-40,000 $40,000-45,000 $45,000-50,000 $50,000-60,000 $60,000-70,000 $70,000-80,000 $80,000-90,000 $90,000-100,000 $100,000-125,000 $125,000-150,000 $150,000-175,000 $175,000-200,000 > 200,000

Income and Expense Information
Monthly Expenses($)	Credit History
	Excellent Good Fair Poor

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