David-Talbot.com - Mortgage Broker

Apply online and save $100 off your application costs.

ABOUT YOU

(* Required field)

Borrower one name:

First Middle Last *

Borrower two name: (if applicable)

First Middle Last

Phone:

Home	( )	*	Preferred number
Business	( )		Preferred number
Cell	( )		Preferred number

Best time to call:

Email address:

FINANCIAL INFORMATION

Employment status:

Borrower One *	Borrower Two (if applicable)
Salary	Salary
Part-time	Part-time
Self-employed	Self-employed
Retired	Retired
Home maker	Home maker
Unemployed	Unemployed

Income per borrower:

Borrower One *	Borrower Two (if applicable)
month	month
year	year

Money in bank accounts:

Savings *

Checking *

Estimated value of
Mutual Funds, 401K's, and IRA's:

Total value (if applicable)

Monthly auto payments:

(if applicable)

Monthly student loan payments:

(if applicable)

Minimum monthly credit card payments:

(if applicable)

Credit status: *

Excellent

Good

Fair

Poor

Authorization to pull credit report? *

Yes

ABOUT YOUR LOAN

Type of loan: *

New mortgage (please fill in NEW MORTGAGE information only)

Refinance (please fill in REFINANCE information only)

NEW MORTGAGE INFORMATION

Do you currently: *

Own

Rent

Do you need to sell your existing home? *

Yes

Have you placed your home on the market yet? *

Yes

Loan amount you're requesting:

Estimated closing date:

REFINANCE INFORMATION

Loan amount you're requesting:

How many years have you owned the property?

What year was the property purchased?

Purchase price:

Current value of property:

(if known)

First mortgage balance:

Second mortgage balance:

(if applicable)

CONGRATULATIONS!
This concludes the first phase of the application process.

Please press the SEND button to
submit your application to David Talbot.

REMEMBER: In order to receive your $100 savings on the application process, ensure all required fields have been filled in. Thank you.