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         * Loan Type:
         * Loan Amount:
         * Loan Term:


Personal Information
Request Borrower Co-Borrower
Salutation:
* First Name:
Middle Initial:
* Last Name:
* Address:
* City:
* State:
* Zip:
* Home Phone:
Work Phone:
* Best Time to contact:
* Email Address:
* Monthly Income:
Employer:
Self Employed:
Length of Employment:
* Date of Birth: ex. 10/09/62 ex. 10/09/62
* SSN:


Credit Information
Request Borrower Co-Borrower
* How is your credit?
* Ever filed for bankruptcy?


Property Information
(Complete the information below for the propery that is collateral for the loan)
Street Address:
City:
State:
Zip Code:
* Month/Year Purchased:
* Property value:
Original purchase price:
* Type of Property:


Existing Mortgage Information
Mortgage Company Balance Payment
First:
Second:
Other:
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Legal Disclosures

 

Equal Credit Opportunity Act "ECOA"

The Federal Equal Credit Opportunity Act prohibits creditors from discriminating against credit applicants on the basis of race; color; religion; national origin; sex; marital status; age (provided that the applicant has the capability to enter into a binding contract); because all or part of the applicantĀ¹s income derives from any public assistance program; or because the applicant has in good faith exercised any right under the consumer credit protection act.
If you have any questions regarding your rights, or if you wish to file a complaint, please contact the management of this financial institution or:

The Federal Trade Commission
Equal Credit Opportunity
Washington, DC 20580


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None of the information provided on this web site constitutes legal, tax, accounting, or other professional advice. All information included on this web site is believed to be accurate, although inaccuracies or typographical errors may exist.

Mortgage interest rates, loan terms, and other information on this web site are subject to change without notice.