Secure Mortgage Application
www.VeriSign.com

Thanks for your interest in a loan. If you are unable to complete a particular part of this application you may leave it blank. I can lock in your interest only after receiving your complete application. Until then, interest rates are subject to change.

 
Purpose of loan
Property will be
Number of units
Purchase date
Purchase price
Down payment
Subject Property Address
Street
City, State, Zip
Description of Current Mortgage(s)
Property value
Loan amount
Current monthly payment
Current interest rate
%
Loan type
Do you have a 2nd mtg?
Yes No
Loan amount on 2nd
Monthly payment on 2nd
Interest rate on 2nd
%
Please complete below for the borrower and co-borrower (if any).
  Borrower Co-Borrower
First name & middle initial
Last name
Social security #
Evening phone (required)
Day phone (required)
E-mail address (required)
  Borrower Co-Borrower
Present address - Street
Address - City
Address - State, Zip
Rent or own? # yrs # yrs
Years employed in current job
Years of employed in current field
Are you self-employed? Yes No Yes No
Total monthly payments on debts, not including current mortgage $ $
Estimated funds available for down payment, closing costs and reserves $ $
Monthly Income Information
  Borrower Co-Borrower
Gross monthly income*
Overtime
Bonuses
Commissions
Dividends / Interest
Net Rental Income
Other**

* Self Employed Borrowers may be required to provide additional documentation such as tax returns and financial statements.
** Notice: Alimony, child support, or separate maintenance income need not be revealed if the Borrower or Co-Borrower does not choose to have it considered for repaying this loan.

Assets:
List checking and savings accounts (name and address of Bank, S&L, or Credit Union with account numbers), along with corresponding cash or market value of each account.
Liabilities:
List name and address of company along with monthly payments, months left to pay and unpaid balance.
Additional Comments / Questions:
The information provided herin is correct to the best of my/our knowledge and by clicking below I/we authorize you to verify any information stated herein including checking our credit with independent service bureaus.
Guarantee Mortgage is licensed as a real estate broker in California,
by the California Department of Real Estate (phone: 916-227-0913), license #01370741.
CA DRE License #01109882