Request A Loan

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Type of Loan
Purchase

Refinance
Home Equity Second Mortgage
Contact Preference
Best time to contact you (check all that apply):
Daytime (9 am - 12 pm)
Afternoon (12 pm - 5 pm)
Evening (5 pm - 9 pm)
Other. Please specify:
Preferred contact (check all that apply):
Home
Work
Cellular Phone
Email
Tell us about you.
Borrower
First Name:
Middle Initial:
Last Name:
Home Phone:
Cell Phone:
Work Phone:
Email Address:
Current Street Address:
PO Box:
City:
State:
Zip:
Own
Rent
How long have you lived there?
  Years and Months
If renting, who is your landlord?
 
If renting, how do you pay?
Check
Cash
Money Order
Co-Borrower
First Name:
Middle Initial:
Last Name:
Home Phone:
Cell Phone:
Work Phone:
Email Address:
Check here if your address is the same as the borrower, otherwise, please provide co-borrower's address.
Current Street Address:
PO Box:
City:
State:
Zip:
Own
Rent
Live with parent
How long have you lived there?
  Years and Months
If renting, who is your landlord?
 
If renting, how do you pay?
Check
Cash
Money Order
If you are interested in a purchase:
Are you working with a realtor?
Yes: Who?
No
Do you have a signed offer on a home?
Yes
No
Do you:  
Have funds to apply toward a down payment?
Have funds to apply to closing costs?
Need 100% financing?
If you are interested in a refinance:
Do you:  
Want to refinance only the balance of your current mortgage to get a better rate or term?
Want to get funds for a debt consolidation?
Want to get funds for home improvements?
Want to get funds for another reason?
How did you hear about us? (Select primary source.)
Referral from
Billboard
Homes Magazine
Newspaper
Chronicle-Tribune Website
Phone Book
Radio
   
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Thank you for giving us this opportunity to work with you.
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