Re-enter Email
Phone:
Date:
Return approval to:
Homeowner Name:
Homeowner Phone:
Property Address:
Email Address:
Owned Since:
Purchase Price:
Estimated Value:
1st Mortgage Balance Outstanding:
Name of Bank:
Monthly Payment:
Interest Rate:
Annual Taxes:
2nd Mortgage Balance:
Name of Bank:
Monthly Payment:
Interest Rate:
Other liens on Property
i.e. IRS, NYS Tax, Mechanics Liens
Amount of Liens
# of Months Behind on Mortgage:
INCOME AND ASSETS OF BORROWER
Borrower Name:
Employer:
Position:
Annual Income:
Years at company:
BORROWER ASSET INFORMATION
Name of Bank:
Bank Balance:
Social Security #:
INCOME AND ASSETS OF CO-BORROWER
Co-Borrower Name:
Employer:
Position:
Annual Income:
Years at company:
CO-BORROWER ASSET INFORMATION
Name of Bank:
Bank Balance:
Social Security #:
Comments:
Office Address:
142 Mineola Avenue
Suite 3B
Roslyn Heights, NY 11577
Telephone:
office:
(516) 294-0100
fax: (516) 717-2228
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