Excel Mortgage, Inc. - Provide clients convenient access to mortgage loan

Quick Online Application

Please provide the following information.

Applicant & Co-Applicant Information (* indicates required fields):

Applicant First Name* Applicant Last Name* Home Phone* Work Phone	SSN* E-Mail* Date of Birth* Years In School

Co-Applicant First Name Co-Applicant Last Name Home Phone Work Phone	SSN E-Mail Date of Birth Years In School

Address City	State Zip

Number of Years at Address
If residing at present address for less than 2 years, please complete the following below:
Address	State
City	Zip

Gross Income:

1.	Applicant Employer Position Years on Job Years in same field If employed in current position for less then two years or if currently employed in more then one position, complete the following. Applicant Employer Position	Monthly Income Amt. $
2.	Co-Applicant Employer Position Years on Job Years in same field If employed in current position for less then two years or if currently employed in more than one position, complete the following: Co-Applicant Employer Position	Monthly Income Amt. $
3.	Other Income Applicant	Monthly Income Amt $
4.	Other Income Co-Applicant	$

Assets

1.	Cash Deposit (Type of Account)	Amount $
2.		$
1.	Checking and Savings Accounts Financial Institution	Amount $
	Account Number
2.	Financial Institution	Amount $
	Account Number

1.	Stocks and Bonds (Please Describe)	Amount $
2.		$
3.		$

1.	Life Insurance	Face Amount $

1.	Automobile Type	Est. Value $
2.		$
3.		$

1.	Other Assets (Please Describe)	Amount $
2.		$
3.		$
4.		$

Refinance:

If refinance, complete the following:

1.	Year Acquired	$
2.	Original Cost $	$
3.	Approximate Loan Balance $	$
4	Approximate Current Property Value $	$
5	If additional properties owned
6	Property Address
7	Present Value
8	Type of Property
9	Amount of Mortgages
10	Monthly Mortgage Payment
10	Rental Income(if you need help, this information is on the third page of the loan application/1003)

If Purchase

Approximate Sale Price	$
Down Payment	$
Subject Property Address
Settlement Date

Comments:

“I authorize Excel Mortgage Inc. to obtain my/our credit report for the purpose of determining credit worthiness. The Information obtained is strictly confidential”
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