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Basic Mortgage Application Form
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Borrower Information
-
Step
1
of 2
1. Borrower Information
Name
*
First
Last
Current Address
*
Address Line 1
Address Line 2
City
--- Select state ---
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Phone
*
Email
*
Purpose of Mortgage or Loan
*
Home Purchase
Refinance
Debt Consolidation Loan
Home Equity Loan
Next
2. Loan / Property Information
Estimated Loan Amount
Type of Property
House
Condo
Townhouse
Duplex
Land
Estimated Price or Value of Property
Property Location
Address Line 1
Address Line 2
City
--- Select state ---
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Down Payment Percentage
Less Than 5%
6% - 19%
20% Or More
Age
Occupation
Household Income
Credit Rating
800 to 850: Excellent
740 to 799: Very good
670 to 739: Good
580 to 669: Fair
300 to 579: Poor
Would you like a referral to a real estate agent?
Yes
No
Were you referred to Freedmont Mortgage Group by a realtor?
*
Yes
No
Realtor Name
Were you referred to, or are you working with, a specific Freedmont Mortgage Group loan officer?
*
Yes
No
Loan Officer Name
Submit