Please contact me for more information
about our services /and products
Jeff Sharp
858.677.4765
Loan Purpose
Purchase Refinance
Property Type
Primary Residence Second Home Investment Property (Not owner occupied)
Street Address
City, State,
Zip
BORROWERS COMPLETE COLUMN 1, CO BORROWERS
COMPLETE COLUMN 2
Contact Information
E-Mail Address (required)
First Name, MI, Last Name
Social Security Number
Home Phone Number
Birthday
Marital Status
Number
of Dependents
Residence For Last Two Years
Your Street Address
City, State,
Zip
Since Mo/Yr
Own
Rent If renting, what is the rent?
Landlord Information if applicable
Street Address
City, State, Zip
Name
and Phone Number
Previous Street Address
City, State. Zip
From/ To Mos/Yrs
Own
RentIf
rented, what was the rent?
Landlord Information if applicable
Street Address
City, State, Zip
Name and
Phone Number
Employment History (2 Year History):
Present
Employer
Address
City,
State, Zip
Phone Number
Fax Number
Gross
Monthly Income
Start Date
Title and
Type of Business
Supervisor's
Name
Supervisors
Phone Number and Fax Number
Previous
Employer (If Less Than 2 years at
current job)
Address
City,
State, Zip
Phone
Number
Fax
Number
Gross Monthly Income
Start Date/
End Date
Title
and Type of Business
Supervisor's Name
Supervisors Phone Number and Fax Number
Other income (if any) exclude rental
income.
Other Income Source (alimony, Child Support,etc.)
How
Long Receiving
Monthly Amount
Other
Income Source
How Long Receiving
Monthly Amount
Asset Information (please complete
for all checking, savings, money market, CD, stock, bond or other
liquid asset accounts) :
Bank or Institution Name
Checking
Balance
Savings Balance
Bank or Institution Name
Checking
Balance
Savings Balance
Bank or Institution Name
Checking
Balance
Savings Balance
Bank or Institution Name
Other Account Balance
Type
of Account (401k,IRA,etc.)
Bank or Institution Name
Other Account Balance
Type of Account (401k,IRA,etc.)
Vehicles Owned:
Year Make Model $ Value
Year
Make
Model
$ Value
Year
Make
Model
$ Value
Debts (Please complete for mortgages,
auto loans and leases, revolving debt or other contractual obligations):
Type of Loan Lender
Monthly
Payment
Balance Owed
Type of Loan Lender
Monthly Payment Balance Owed
Type
of Loan
Lender
Monthly Payment Balance Owed
Type
of Loan
Lender
Monthly Payment Balance Owed
Real Estate
Owned:
Type of Property (Primary,Secondary,Rental)
Street
Address
City,
State, Zip
Lender
Monthly Payment Balance Owed
Property
Value Rent Received Monthly, if any
Type of Property (Primary, Secondary,Rental)
Street Address
City,
State, Zip
Lender
Monthly Payment Balance Owed
Property
Value Rent Received Monthly, if any
Refinance loans only, information on
your existing mortgage:
Type of Loan:
FHA
VA Conventional
Lender
Monthly Payment Balance Owed
Property
Value Account Number
What is your current interest rate?
What are you looking to accomplish? Lower rate? Cash out to
pay off bills or home improvements? Lock in an adjustable?
If purchase then:
Where is the down payment coming
from?
(Bank account, Sale of current home, Gift,etc.)
How much of a sales price would you like to
qualify for?
Would you be interested in looking at a zero
money down option?Yes No
Please include any other important information about
the purchase of your new home.
:
OR
Go back to Free home finder service.
For additional information
you can also call Jeff at
800.535.5911 x 4765 or visit
www.chasemortgage.com.
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