Loan Application

Borrower Information  Title Mr. Mrs. Miss  First*  Middle  Last* Present Address  Street  City  State* AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY    Zip  SSN#* Age Contact Numbers  Home*  Work   Cell   E-mail Co-Borrower Information (If any)  Title Mr. Mrs. Miss  First  Middle  Last Present Address  Street  City  State AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY    Zip  SSN#  Age Contact Numbers  Home  Work  Cell   E-mail Employment (Borrower)  Self Employed?  Employer:  How Long (Yrs/Mths):   /  Monthly Income: $  Overtime: $  Bonuses: $  Commissions: $  Other: $ Employment (Co-Borrower)  Self Employed?  Employer:  How Long (Yrs/Mths):   /  Monthly Income: $  Overtime: $  Bonuses: $  Commissions: $  Other $ Assets (Borrower)  Checking: $  Savings: $  CD's/Stocks/Bonds $  401K's/IRA's $ Assets (Co-Borrower)  Checking: $  Savings: $  CD's/Stocks/Bonds $  401K's/IRA's $ Liabilities (Combined for both Borrower & Co-Borrower)  Type Monthly Payment  Unpaid Balance   Credit Cards: $  $   Auto Loans: $  $   Other Loans: $  $   Child Support: $  Subject Property Information  Street:  City:  State: AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY  Zip:  Number of units:     1 2 3 4  Occupancy type:     Secondary Residence Primary Residence Investment  Estate Held:     Fee Simple Leasehold  Property Value:  $  Desired Loan Type What is the type of mortgage loan? VA Conventional FHA FmHA Other What is the purpose of this loan? Purchase Refinance Construction Construction-to-perm Other  If you selected "Refinance", what is the purpose? Change in Rate/Term Cash Out Home Improvement Debt Consolidation Change in Loan Type  If you selected "Other", please explain. What is the desired loan amount? $  What is the estimated purchase price? $  What is the estimated down payment amount? $  If refinance, what is the total owed on home? $  What is the length of your requested loan in months?       84 (7years) 120 (10 years) 180 (15 years) 240 (20 years) 360 (30 years) Amortization Type:       Fixed Rate GPM ARM Other  Miscellaneous  Which describes your situation? I am a first time home buyer I need to sell my existing house before I buy another I am only interested in a pre qualification I am not ready to buy yet I am working with a Realtor and ready for financing! I have not hired a Realtor yet but I'd like to get started I want to refinance and get cash out. I want to do a streamline refinance of my VA or FHA loan Other   I have found a realtor.    Additional Comments:  Agents Name:  Company:  Phone Number:   I need a realtor, please have one contact me.      * I/We (borrower[s] named herein) understand that this form is for pre-qualification only and is not an application. Authorization to check credit verification YES NO By selecting "YES" to this radio button, I/WE hereby authorize Pacific Inland Financial to order a consumer credit report to verify credit and other information pertaining to pre-qualification. The information that The Tom Bass Team obtains is only to be used for mortgage pre-qualification purposes.    Email Address:

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