Refinance Mortgage Application (651) 552-3681
Borrower Basic Information

* = Required Information

Is there a co-borrower? No  Yes
  If yes, co-borrower name
  If yes, co-borrower information can be entered on the next page
but include their assets (checking/savings) on this page
Your FULL Name (First, MI, Last) *
Email address * Required
Best Phone # *    Home or Cell
  2nd best phone #   Home or Cell
Current Address *  
  State   Zip  
How long have you lived here  years  months
Do you currently
Old Address
(if at current less than 2 years)
  State  Zip
  Did you 
  How long did you live there  years  months
Date of Birth (format mo/da/year)  Required
Social Security Number  Required
Marital Status
Years of Schooling
Any dependents?  No  Yes
   If yes, how many? . Ages 
Are you US Military?
Your Credit
 Credit Score  
  Ever File Bankruptcy?  
  If Yes, How long discharged?  Years
  Ever have a Foreclosure?
  If Yes, How long long ago?  Years

Borrower Employment

  State  Zip 
Work Ph#  (REQUIRED for verification of employment)
Position/Title with Company
Time with Current Employer  Years  Months
How long in this line of work? Years
Are you self employed?
Previous Employer (if less than 2 years with current employer)
  State Zip
  You worked there from when to when mo /yr
  until mo / yr
  Old Income , per 
  Former Position/Title 

Contacting You

We usually attempt to contact you between 10:00 AM & 6:00 PM Monday - Friday. If we are unable to contact you during this time frame, it could delay your application.
Daytime Contact  at 

Basic Loan Information

Purpose of loan
Type of Loan 
Amortization Term:  10-yr to 30-yr available
Property is our


Current Monthly Payment $
  Does this include escrows? YES   NO
Current Interest Rate? %
Current Mortgage  Company Name? 
Escrow on new loan? YES, escrow  NO, I'll pay separately
Who owns your mortgage?  Check Fannie Mae   Check Freddie Mac
Current Property Taxes $.
  Homeowners Insurance $ (if known)
Year bought  .
Original Cost $
Today's Estimated Value $
Estimated Remaining Balance $
Estimate Loan Amount Needed $
Do you have PMI on your loan? YES NO 
Have a 2nd Mortgage/Equity Loan?  YES NO
  If yes, how much do you still owe? 
Keep or consolidate 2nd mortgage? Keep Consolidate
How to pay closing costs?

Subject Property Information:

Same as mailing address?  Yes  Listed below
  State  Zip (we lend in MN, WI, IA, ND, SD only)


YOUR Monthly Income: (Gross, pre-tax)

Base Income $  per 
Net Rental Income
Other  (Child Support, Social Security, Pension, etc)
  Explain 'other' ncome 

Assets: (Include all Applicants)

(includes checking, savings, stocks, mutual funds, etc.) (Include all Applicants Assets)
Account 1 $ Name of Bank 
Account 2 $ Name of Bank 
Account 3 $ Name of Bank 
All additional accounts $
Stocks and Bonds $ Name of Bank 
401(k)/Retirement $
Net Worth of Businesses Owned $

Liabilities: Who do you owe? (Include all Applicants debts)

Alimony/Child Support

All other debts of ALL applicants (car loans, credit cards, student loans, etc) List only estimated minimum required monthly payments
  Estimated Total unpaid balance(s) $

Own Other Properties:

Own any other property? If yes, answer following questions
1st property address  
  St  Zip
2nd home or rental? Rental   2nd Home
What is rent $ (if rental)
2nd property address  
  St  Zip
2nd home or rental? Rental   2nd Home
What is rent (if rental)


A. Are there any outstanding judgments against you?
B. Have you been declared bankrupt within the past 7 years?
C. Have you had property foreclosed upon or given title or deed in lieu thereof in the last 7 years?
D. Are you a party to a lawsuit?
E. Have you directly or indirectly been obliged on any loan which resulted in foreclosure, transfer of title in lieu of foreclosure or judgment?
F. Are you presently delinquent or in default on any Federal debt or any other loan, mortgage, financial obligation, bond, or loan guarantee?
G. Are you obligated to pay alimony, child support, or separate maintenance?
H. Is any part of the down payment borrowed?
I. Are you a co-maker or endorser on a note?
J. Are you a U.S. citizen?
K. Are you a permanent resident alien?
l. Do you intend to occupy the property as your primary residence?
M. Have you had an ownership interest in a property in the last three years?
(1.) What type of property did you own Principle residence (PR), second home (SH), or investment property (IP)?
(2.) How did you hold title to the home - solely by yourself (S), jointly with your spouse (SP), or jointly with another person (O)?

Government: Information for lender monitoring purposes

 I do not wish to answer
Ethnicity:  NOT Hispanic or Latino
   Hispanic or Latino
Gender  Male   Female

Other Information:

Please write in any other information you feel is important to us, or you need to explain, or answers to any YES questions in the declarations section.
How did you find out about us   This help's keep our advertising dollar effective, therefore reducing YOUR closing costs!




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