Address of Property being Purchased
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
Agent
Phone Number
Employment Information:
Please complete this section if you have been with your current employer
for less than 2 years:
Please complete this section for a 2nd job or additional employers.
Asset Information:
For this section, please only give approximate figures in each account area.
There is no need to give account numbers in which the monies reside.
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?
Debt Information:
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. 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:
Disclosure Information:
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:
Mortgage Options
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?
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
3/1 year arm
5 or 7 year arm
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 Main Street Mortgage 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