Applied Wholesale Mortgage - Short Mortgage Application Form

	Short Application
	Apply by Phone

Short Application Form

Name the Rate and Points you want

I would like a rate of % with points.

How did you find out about us?
or other

Property Information

Purpose of Loan * Required

Property Value * Required
$

Loan Program * Required

Loan amount you are applying for * Required
$ or % Down payment

Total Cash / Assets available Source of Down payment
$

I can obtain a gift from relatives if necessary.

Where is the property located? * Required
City , State
ZIP

Property type * Required

Use of property * Required



Borrower Information

First Name Middle Name Last Name * Required

Social Security Number	- -
Email address * Required
Home Phone Number * Required	- -
Work Phone Number	- - ext.
Fax Number	- -
Contact Me At * Required
Best time to call * Required

Gross Monthly Income
I can I cannot - document my income
Salary	$
Commission (2 year avg.)	$
Other	$
Min. Monthly Debt Payments (do not include housing payments)	$

Credit History * Required
I have Excellent Credit with no late payments or
I have some credit challenges Please answer the following questions. I have had late housing payments in the past 12 mo. I have had late credit payments in the past 12 mo. I have collection accounts that are unsettled. I have collection accounts that are settled. I declared bankruptcy. My bankruptcy was discharged

(If you have Co-Borrower, please complete the information below)

Co-Borrower Information

First Name Middle Name Last Name

Social Security Number	- -
Email address
Home Phone Number	- -
Work Phone Number	- - ext.
Fax Number	- -
Contact Me At
Best time to call

Gross Monthly Income
I can I cannot - document my income
Salary	$
Commission (2 year avg.)	$
Other	$
Min. Monthly Debt Payments (do not include housing payments)	$

Credit History
I have Excellent Credit with no late payments or
I have some credit challenges Please answer the following questions. I have had late housing payments in the past 12 mo. I have had late credit payments in the past 12 mo. I have collection accounts that are unsettled. I have collection accounts that are settled. I declared bankruptcy. My bankruptcy was discharged


Borrower and Co-Borrower
Credit Report I authorize Applied Wholesale Mortgage to obtain my/our credit report. Yes No * Required Please enter your current address for credit verification , Explain any special circumstances:

It's simple.

It's guaranteed...

The way a loan should be.