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Step
1
of 2
Please Select Your Loan Officer
*
Select
Travis Smith
Brandi Mays
Fairlen Browning
Shannon Stewart
Whitney Basemore
Brittany Clark
Azuree Browning
Trisha Cruse
Any
How Were You Referred to Us?
*
Friend
Realtor
Web Site
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Other
Referral Name or Source
Are You Looking to Purchase or Refinance?
*
Purchase
Refinance
Borrower Information
Name
*
First
Middle
Last
Current Address
*
Address Line 1
Address Line 2
City
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
*
Social Security Number
*
Date of Birth
*
Do you currently:
Rent
Own
How Long?
*
Current Payment
*
Marital Status
Single
Married
Separated
Widow
Any Dependents?
*
Yes
No
What are their ages?
separate ages by commas
Borrower Income
Employer 1:
*
Length
*
City
*
Position
*
Wage Type
*
Salary
Hourly
Other
Amount
*
Frequency
*
weekly
biweekly
semi-monthly
monthly
Employer 2:
Length
City
Position
Wage Type
Salary
Hourly
Other
Amount
Frequency
Weekly
2x Month
Monthly
Any Other Income?
*
Yes
No
Source
Borrower Assets
List Any Assets
Co-Borrower Information
Name
First
Middle
Last
Current Address
Address Line 1
Address Line 2
City
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
Social Security Number
Date of Birth
Do you currently:
Rent
Own
How Long?
Current Payment
Marital Status
Single
Married
Separated
Widow
Any Dependents?
Yes
No
What are their ages?
separate ages by commas
Co-Borrower Income
Employer 1:
Length
City
Position
Wage Type
Salary
Hourly
Other
Amount
Frequency
weekly
biweekly
semi-monthly
monthly
Employer 2:
Length
City
Position
Wage Type
Salary
Hourly
Other
Amount
Frequency
Weekly
2x Month
Monthly
Any Other Income?
Yes
No
Source
Co-Borrower Assets
List Any Assets
Next
Please upload copies of the following information (JPG, PNG, PDF)
Most recent pay stubs*
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*30 days worth required.
Drivers license
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Most recent bank statement
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W2's (2years)
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Other
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