Short Mortgage Application

Please submit the following information to get your loan started with us. If you prefer, you can download an application, fill it out, and fax back to us at 719-218-9191.

If you have any questions, please use the Live Help/Chat link or give us a call and we'll be happy to walk you through the form.

Borrower Contact Information (Required information fields appear in bold)

First Name	M.I.	Last Name
Street	City	State AK AL AR AS AZ CA CO CT DC DE FL GA GU HI IA ID IL IN KS KY LA MA MD ME MI MN MO MP MS MT NC ND NE NH NJ NM NV NY OH OK OR PA PR RI SC SD TN TX UT VA VI VT WA WI WV WY --	Zip
Home Phone		Business Phone x
Mobile/Pager/Alternate		Fax
Social Security Number
Email Address
Contact Me at Select One Home Work		Best Time to Call Select One Morning Afternoon Evening
Referred by

Co-Borrower Contact Information (if applicable)

First Name	M.I.	Last Name
Street	City	State AK AL AR AS AZ CA CO CT DC DE FL GA GU HI IA ID IL IN KS KY LA MA MD ME MI MN MO MP MS MT NC ND NE NH NJ NM NV NY OH OK OR PA PR RI SC SD TN TX UT VA VI VT WA WI WV WY --	Zip
Home Phone		Business Phone x
Mobile/Pager/Alternate		Fax
Social Security Number
Email Address
Contact Me at Select One Home Work		Best Time to Call Select One Morning Afternoon Evening

Loan Information

Loan Purpose Purchase Refinance	Loan Type Select One Fixed ARM
Property Type Select One Primary Residence Second Home/Vacation Home Investment Property

Purchase Price $

Amt Avail for Down Payment or Closing Costs $

Personal Information

Total Household Gross Yearly Income (Income Before Taxes) $
Total HouseholdMonthly Debt Payments (including Alimony & Child Support) $
Borrower Current Employer	Co-Borrower Current Employer
No. Years	No. Years
Do you authorize us to pull your credit report in order to pre-qualify you for a loan? (If so, please be sure to provide your social security number). Yes   No
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