Fast Start Loan Application Attention: Randall Land
America’s Premier Mortgage Office: 281 681 0700 Fax: 281-681-0715
Borrower:________________________________ Marital Stat: (S) (M) (Un-Mrrd.)
Social Security Number:______________________ Date of Birth:__________________
Co-Borrower:______________________________ Marital Stat: (S) (M) (Un-Mrrd.)
Social Security Number:______________________ Date of Birth:__________________
Current Address:___________________________ No. of Dependent(s) ______ Age(s)______
City:__________________________ State:_________________________ Zip:_________________________
Home Phone:________________ Borrower Cell:__________________ Co-Borrower Cell_________________
Employment
Borrower's Employer_______________________________________/ Gross Mo. Income $_______________
Address:___________________________________________ Work Phone:___________________________
City:__________________________ State:_________________________ Zip:_________________________
Length of Employment:_______________ Position Held:_________________________________/(1099) or (W2)
Co-Borrower's Employer___________________________________ / Gross Mo. Income $________________
Address:___________________________________________ Work Phone:___________________________
City:__________________________ State:_________________________ Zip:_________________________
Length of Employment:_______________ Position Held:_________________________________/(1099) or (W2)
ASSETS (List accounts where cash assets are held, checking, savings, investments, etc.)
Name___________________________(Chk, Sav, Inv.) Avg. Balance___________________________
Name___________________________(Chk, Sav, Inv.) Avg. Balance___________________________
Name___________________________(Chk, Sav, Inv.) Avg. Balance___________________________
Current Monthly Housing Expense/Rent:______________________ Rent or Own
Can you provide cancelled checks or money order receipts for rent for the last 12 months? Yes___ No____
Byers Real Estate Agent MIKE COLEMAN
How much house are you wanting to Purchase/Refinance_______________________
How much down payment are you prepared to make______________________ Waive Escrows? Yes or No
I hereby authorize America's Premier Mortgage to access my credit report for the purpose of mortgage financing.
X______________________________________________X__________________________________________ Borrower Date Co-Borrower Date
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