New Short Prospect Application

Loan Officer*

Processor

Referral Source

Follow-up Date

Please Tell Us About Primary Borrower:

First Name*

Middle Name

Last Name*

Suffix

Social Sec. No.

Birth Date*

Age

Cell Phone*

Home Phone

Work Phone

Extension

Email Address*

Contact Method

Preferred Language

Citzenship

Gender

Marital Status

Dependents

Credit Score*

Present Address:

Street Address

Unit#

City

State

Zip Code:

Country

Time at this Address

Own/Rent

Monthly Rent($)

Additional Borrowers:

First Name

Middle Name

Last Name

Email Address

Gender

Marital Status

Credit Score

Loan Information:

Property Address

Unit #

City

State*

Zip

Country

Property Type*

No. of Units

Year Built

Legal Description

Mixed-use property

Construction Method

Mortgage Details:

Loan Purpose*

Residence Type*

Loan Type*

Amortization Type

Lien Position

Purchase Price*

Down Payment(%)*

Down Payment Amount

Down Payment Source

Exp. Closing Date

Earnest Money

Purchased Yr Of this Property

Original Purchased Price

Current Loan Balances*

Purpose of Refinance*

Property Appraisal Value*

Loan Amount*

Loan to Value(%)

Payment Term*

Due In Mths

Int Rate(%)

Rate & Term Expectation

Notes/Comments

Do you Own Other Properties?

Total Net Rental Income?

Street Address	Property Type	Status	Subject property	Market Value	Net Income	Owned By	Action

Monthly Income
Details

Work for family owned business?

Business Owner / Self-Employed?

Base Income
Overtime
Bonuses
Commission
Military Entitlement
Other Income
Net Rental Income
Total Income

Total Income:

Debt-To-Income: /

Subject Home Expenses

First Mtg
Other Fin
PMI
Taxes
Haz Ins
HO Assoc
Total
Monthly Expected Rent
Occupancy %
Net Rent

Other Loans/Liabilities










Net Rental Exp
Total Liabilities

Enter Code*