Property Information

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

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Employment Information:

Borrower's Employer's Name & Address: Position How long employed here? Gross Monthly Salary Click the button if Self-Employed

Co-Borrower's Employer's Name & Address: Position How long employed here? Gross Monthly Salary Click the button if Self-Employed

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Please complete this section if you have been with your current employer for less than 2 years:

Borrower's Previous Employer Name & Address: Position Dates employed here to Gross Monthly Salary Click the button if Self-Employed

Co-Borrower's Previous Employer Name & Address: Position Dates employed here to Gross Monthly Salary Click the button if Self-Employed

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Please complete this section for a 2nd job or additional employers.

Borrower's Second Employer Name & Address: Position Dates employed here to Gross Monthly Salary Click the button if Self-Employed

Co-Borrower's Second Employer Name & Address: Position Dates employed here to Gross Monthly Salary Click the button if Self-Employed

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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.

Savings Institution Checking Institution Money Markets Institution

401K Plans Institution Mutual Funds Institution Stocks & Bonds Institution

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?

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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.

Combined Credit Cards: Approximate Balance Monthly Payment Car Loan #1: Approximate Balance Monthly Payment Car Loan #2: Approximate Balance Monthly Payment School Loan #1: Approximate Balance Monthly Payment

School Loan #2: Approximate Balance Monthly Payment Personal Loans: Approximate Balance Monthly Payment 1st Mortgage: Approximate Balance Monthly Payment 2nd Mortgage: Approximate Balance 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 ?

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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:

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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:

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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