Home Page
Loan Process
Mortgage Calculators
Mortgage F.A.Q.'s
Glossary of Terms
Loan Programs
Refinance Checklist
Purchase Checklist
Mortgage Application
Contact Us


  • Use this form to request mortgage information.
  • Please fill out as much of this form as possible.
  • When finished click the "Submit Form" button.
  • If you prefer to speak to a loan officer please contact us via email and someone will contact you within 24 Hours.

Notice: Filling out this form does not lock in rate nor guarantee rate protection of any kind.  Loan applications must be confirmed verbally with a representative.

Please call us at the above number to lock-in rate and/or to have us answer any of your questions. A loan officer may contact you. A phone number is required.

The information you enter on this form will be kept in strict confidence.
 

PLEASE DO NOT USE DOLLAR SIGNS ($) OR COMMAS ( , ) 
WHEN ENTERING NUMBERS.
 
Mortgage Type:
1st 2nd Home Equity
Amount Requested:
$

 

 
Property To Be Financed (if known)
Address:
Apt. or Unit# :
City:
State:
Zip:
 

IF REFINANCING FILL OUT THE FOLLOWING INFORMATION
When did you purchase? yr. mo.
What was the purchase price? $
What do you think it is worth today? $
Do you own other properties?

Yes No

 If so how many?
Existing Mortgages 1st Mortgage 2nd
Please enter below the monthly information for:
  Mgt. Balance $ $
Taxes & Insurance Monthly Payment 
(Are taxes and insurance included in your payment? Yes)		 $ $

 


IF PURCHASE FILL OUT THE FOLLOWING INFORMATION
When do you expect to purchase?
yr.  mo. 
When will home be completed?
yr.  mo. 
What is the purchase price?
$
What is your down payment?
$
Do you own other properties?

 
Yes No
 If so how many?

 
Personal Information
  Applicant Co-Applicant
First Name
Last Name
Social Security Number
Date of Birth ( 00/00/0000 )
E-Mail 
Home Phone
Work Phone
How would you rate your credit?
Are you married to the
Co-Applicant?		  
Best time to contact you?

 
Current Address
Did you?
How long?
 yrs.  mo
Address:
 
 
Apt. or Unit# :
City:
State:
Zip:
Previous Address 
 (if less than 2 yrs. at current)
Did you?
How long?
 yrs.  mo
Address:
 
Apt. or Unit#:
City:
State:
Zip:



Employment History
  Applicant Co-Applicant
Employer Name
Gross Monthly Income*
Your Position (title)
Self-Employed Yes No Yes No
Length with Company
yrs. mos.
yrs. mos.
Phone Number


 

Previous Employer   (if less than 2 yrs. at current)
Employer Name
Gross Monthly Income
Your Position
Length of time with Company yrs. mos.
yrs. mos.
Phone Number


 

Comments and/or Additional Comments

* Before taxes & deductions
By submitting this on-line application, I/We authorize Painless-Mortgage.com to check such information as my/our credit, business and employment status and history. Submitting this application does not lock-in rate. Please call us at 800-871-7135 if you have any questions. Privacy Statement.

 

© 2006 All Rights Reserved. Privacy Statement.
Any use of the content within this site, including but not limited to, images, text and/or java scripts
without permission from Painless-Mortgage.com is prohibited. Contact info@Painless-Mortgage.com for more information.