Online Mortgage Loan Application

Instructions

Use this online application to request mortgage information.
Please fill out as much of the loan application as possible.
When finished click on the send button.

A mortgage loan officer will contact you. A phone number is required.

General Information

	Borrower	Co-borrower (If different)
Full Name:
Address:
City, State, Zip
Home Phone:
Work Phone:
Best time to contact:
E-mail:
Social Security #:
Employers:
Employers' Phone Number:
Are you self employed ?	Yes No	Yes No
Length of Employment:
Gross Monthly Income:
Date of Birth:
My credit history is:	excellent good, but late some credit problems major credit problems don't know	excellent good, but late some credit problems major credit problems don't know

Loan Request

Amount Requested:
Type of loan:	Purchase Refinance 2nd Mortgage Equity Line Other

Property Information

(This information needs to be filled out for property that is collateral for the loan)

Street Address:
City, State, Zip Code:
Estimated Present Value:
Year Purchased:
Original Price:
Type of Property:	Primary Second/Vacation Investment
Purchase Amount:

Loan Information

Mortgage Balances	Amount:	Held by:	Payment:
First:
Second:
Other:

Creditors	Amount Owed	Monthly Payment	Will you pay this off ?
	$	$	Yes No
	$	$	Yes No
	$	$	Yes No
	$	$	Yes No

Other monthly debts and information - please describe

By submitting this online application, We authorize Webb Mortgage Direct to check
such things as my/our credit, business and employment status and histories.