Address
What is your living status? Own Rent Live with relatives
How long have you lived here?
How much is your current housing expense?
What type of mortgage do you currently have?
Previous Address (If less than 2 years at current address)
E-Mail Address
Date of Birth
Sex Male Female
Years of Schooling
Number of Dependents
Ages of Dependents
Marital Status Married Single Separated
Social Security Number
Home Phone Number
Work Phone Number
Are you a U.S. citizen? Yes No
If not,do you have a green card? Yes No
Are you obligated to pay alimony or child support? Yes No
Sale Price
Annual Taxes
Has the seller accepted the contract? Yes No
Is the Property... single family? duplex? triplex?
Will you use the property as... primary residence? vacation home? investment?
Is this property a... condominium? townhome? fee simple home?
Is there an association fee? Yes No
If yes, How much monthly?
Who is the Realtor that helped to complete the contract? Company and Address
Agent
Phone number
Who is the Realtor that had listed the property for sale?
Company and Address
Phone Number
Position
How long employed here?
Gross Monthly Salary
Click the button if Self-Employed
Please complete this section if you have been with your current employer for less than 2 years:
Dates employed here to
Please complete this section for a 2nd job or additional employers.
Checking Institution
Money Markets Institution
Mutual Funds Institution
Stocks & Bonds Institution
Any other liquid assets you feel are applicable:
Are any of the above stated funds not to be used for purchase of new real estate:
Do you have any potential gift monies coming from a family member? YES NO
What is their relationship to you?
If YES, what would the amount be?
The following debt information is a critical aspect of this financial analysis. We will give you several general categories of possible revolving debt to fill in. These may not be all-inclusive, so please use the 'other' section to include your unique situation. Revolving debt is defined as any constant, monthly payments you make. (ie: car payments, home equity loan, school loans, credit cards...)
Please give both the current total balance of the debt as well as the current monthly payment.
Car Loan #1: Approximate Balance Monthly Payment
Car Loan #2: Approximate Balance Monthly Payment
School Loan #1: Approximate Balance Monthly Payment
Personal Loans: Approximate Balance Monthly Payment
1st Mortgage: Approximate Balance Monthly Payment
2nd Mortgage: Approximate Balance Monthly Payment
Please continue with any other revolving debts you may have that do not fit in the categories listed above:
Have you ever been previously married? YES NO
If YES, is there any alimony/child support, and how much on a monthly basis?
How long will payments continue ?
If you currently own will you be selling the property prior to buying the new property? YES NO
If you are selling/or will sell this property prior to your new purchase, what will the approx. net proceeds equal?
If you are not selling this property, what will your total monthly cost be to maintain it (ie: loan payments, taxes & Insurance)
If you own a second or third home please give the same info for them in the space provided below:
Will you occupy the new premises? YES NO
Have you in the last 7 years declared bankruptcy, suffered foreclosure, had an account assigned for collection or had any legal action affecting your ability to finance? YES NO
If, YES, explain below:
Are you a US citizen ? YES NO
If NO, are you a US Resident Alien? YES NO
Do you have Veteran's status ? YES NO
If YES, are you a reservist? YES NO
Is any part of the purchase price or settlement cost being obtained from a source other than shown? YES NO
If you answered "YES" and the money in question is other than monies mentioned in the gift section above, please describe below:
Please complete the following section to indicate your preference for your financing. Your mortgage counselor will be calling you to answer any questions and confirm your selections. At that time you will be given instructions on how to lock in on current interest rates.
How long do you think that you will own the new home that you are financing? 0-5 years 5-10 years 10-15 years 15 or more years
What mortgage term do you prefer? 10 years 15 years 20 years 30 years
How many points are you considering? None One Two Three
What loan program are you considering? Fixed 1 year arm FHA 3/1 year arm VA 5 or 7 year arm Buydown COFI adjustable 5 or 7 year balloon Other
How much of a loan are you requesting?
Completing this information does not guarantee mortgage approval. This should not be considered an extension of credit. I/We hereby authorize Madison First Financial to obtain a credit report in my/our names, for mortgage application purposes only. The RESPA Act prohibits lenders from distributing credit reports to any third party.
Please run my credit Do Not run my credit
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