Secure 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 *
Best Phone # *    Home or Cell
2nd best phone # 
  Home or Cell
* Work Phone #  (REQUIRED for verification of employment)
Current Address *  City  State  Zip  
How long have you lived here  years  months
Do you currently
Old Address
(if at current less than 2 years)
Address 
 City State  Zip
Did you 
. How long did you live there  years  months
Date of Birth (format mo/da/year)  Required
Social Security Number  Required
Credit  Ever File Bankruptcy?  If Yes, How long discharged? Years
Marital Status
Years of Schooling
Any dependents?   No  Yes. If yes, how many? . Ages 
Are you a Military Vet?
   

Borrower Employment

 
Employer
Address  City  State  Zip 
Position/Title with Company
Time with Current Employer  Years  Months
How long in this line of work? Years
Are you self employed?
Former Employer (if less than 2 years with current employer)
Employer 

Address 
 City 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 (Refi, Purchase)
Type of Loan (Fixed, ARM, FHA, etc) 
Amortization Term:  6 yr - 30 yr available
Estimate Loan Amount Needed $
Property will be our
I applying today for
Estimated Closing Time
   

Purchasing a home?

Answer these additional questions: (skip if refinancing)
What is the Purchase Price?  (estimate if pre-approval)
Down Payment %
Amount of Down Payment $ .00
Source of Down Payment:
Property Taxes on New Home? $  (if known)
Are you working with a Realtor?   Yes, info below  No realtor yet  Please refer a great one
Realtors Info: Name  Ph#  Email
   

Refinancing?

Answer the following additional questions: (skip if purchasing)
Your Current Monthly Payment is: $ Does this include escrows? YES   NO
Your Current Interest Rate? %. Current Mortgage Company Name? 
Do you escrow for taxes & Insurance? YES NO
Who owns your mortgage?  Check Fannie Mae   Check Freddie Mac
Current Escrows: Property Taxes $. Homeowners Insurance $ (if known)
About this property? Year purchased? . What was the original cost? $
Today's Estimated Value $
Estimated Remaining Balance $
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:

The Home you are buying or refinancing
Same as mailing address?  Yes (refinance)
Found property?  Yes (address below)   No (Still Looking)
Address: City   State  Zip
:

(we lend in MN, WI, and SD only)

Monthly Income:

Gross Monthly Income (Pre-Tax)
Base Income $  per 
Overtime
Bonuses
Commissions
Dividends/Interest
Net Rental Income
Other  (Child Support, Social Security, Pension, etc)
Explain Income 
   

Current Housing Costs:

 
Rent
First Mortgage Payment (P/I)  Hazard Insurance  Property Taxes 
  PMI  Homeowner Assn. Dues 
Second Mortgage Payment (P/I)
   

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 $
Automobiles Owned 1 Yr/Make. Estimated Vale $ 
Automobiles Owned 2 Yr/Make. Estimated Vale $ 
   

Liabilities:

Who do you owe? (Include all Applicants debts)
Current 1st Mortgage Co
 or Landlord Name
. Monthly payment 
Current 2nd Mortgage Co . Monthly payment 

Alimony/Child Support

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

Own Other Properties:

 
Own any other property NO YES
If "Yes" - What is it worth? $ How much do you owe on it? $

What is the payment?

$
First other property address  City St  Zip
Second other property address  City St  Zip
   

Declarations:

 
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 Government Lender Monitoring purposes
 I do not wish to answer
Race
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 making our decision, 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!
   

Finish:

 

 

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