| Is this a purchase or refinance? |
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| If a purchase, what is the purchase price? |
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| If a Purchase, do you intend to occupy it as your primary residence? |
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| If a Purchase, how much money do you have for a down payment & closing costs? |
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| If a Refinance, How much do you owe on your current mortgage? |
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| Do you want cash out for any reason? |
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| If yes, how much do you need? |
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| Are you looking for a new 1st Mortgage or a 2nd? |
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| Estimate your property's market value |
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| What type of property is it? |
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| Is the subject property your primary residence? |
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| Borrower Information: |
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| First Name |
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| Middle Initial |
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| Last Name |
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| Social Security # |
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| (if you prefer, we can collect over the phone later) |
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| Birthdate |
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| Street Address |
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| City |
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| State |
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| County |
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| Zip |
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| Phone Number |
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| Cell Phone Number |
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| Fax # |
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| Email Address |
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| What is your gross monthly income? |
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| Can you prove your earnings with W-2's or Tax Returns? |
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| Are you Self-Employed |
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| How long have you been on the job (or Self-Employed)? |
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| Co-Borrower Information: |
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| First Name |
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| Middle Initial |
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| Last Name |
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| Social Security # |
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| (if you prefer, we can collect over the phone later) |
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| Street Address |
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| City |
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| State |
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| County |
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| Zip |
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| What is your gross monthly income? |
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| Are you Self-Employed? |
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| How long have you been on the job (or Self-Employed)? |
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| Can you prove your earnings with W-2's or Tax Returns |
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| Can we pull your Credit and Forward your application to a Crossroads Mortgage Loan Officer near you? |
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| If you do not wish us to pull your credit, please call our toll free line for a free consultation. |
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| How do you prefer to be contacted? |
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| I was referred to you by: |
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