YOUR MORTGAGE PLANNING QUESTIONNAIRE

My commitment to you is to help you make informed choices about your financing options when buying or refinancing your home.

There are several different ways to finance a home but to find the best option for you I must take into consideration your long and short term financial goals as well as your payment and equity objectives.

Accordingly, please take a moment and complete the attached questionnaire and information sheets prior to our Mortgage Planning Consultation and email or fax it back to me at (703) 707-8584.

During our consultation I will work with you to outline your goals, analyze your current situation and then recommend several different strategies that will enable you to achieve your goals.

Thank you for taking the time to respond to these important questions.

Kind Regards,

Mike Caddy

Mortgage Planner

Part One: Preliminary Questionnaire
  1. What are your primary goals for this home buying or refinance process?
  1. If purchasing, what price range are you considering? $ to $

How much will your down payment be? $ or %

  1. What type of property do you plan to purchase, or if you are refinancing what type of property do you currently own?

Condo Townhouse Single Family Detached

  1. Will the property be, or is it currently:

Primary Residence Second Home Investment

6. How long do you intend to own or remain in this property?

1-5 years 6-10 years 11+ years

7. Do you own investment property? Yes No # of Properties:

8. Have you ever filed for bankruptcy? Yes No

Date Filed: Date Discharged

9. Do you authorize Nations Home Funding/Churchill Mortgage to run your credit? Yes No

Part Two: Client Data Sheet

Borrower Information:

First, Middle Initial, Last NameSocial Security #Birth Date
Home Phone #Work Phone #Cell #

Current Address City/State/Zip Code Dates

Own Rent: $ month

Previous Address City/State/Zip Code Dates

Please list if in current residence for less than 2 years

Own Rent: $ month

Current Employer/AddressPosition/Title Dates

Previous Employer/Address Position/Title Dates

If less than 2 years with current employer

Co-Borrower Information:

First, Middle Initial, Last NameSocial Security #Birth Date

Home Phone # Work Phone # Cell #

Current Address City/State/Zip Code Dates

If different than Borrower’s current address

Own Rent: $ month

Previous Address City/State/Zip Code Dates

Please list all addresses for last two years if different than borrower’s previous address

Own Rent: $ month

Current Employer/AddressPosition/TitleDates

Previous Employer/AddressPosition/TitleDates

If less than 2 years with current employer

Income Information

Borrower: Are you: Salaried Hourly Commissioned/Self Employed

Co-Borrower: Are you: Salaried Hourly Commissioned/Self Employed

Note: Please enter “Gross Monthly” amounts in the blanks below.

Borrower Co-Borrower

Salary or Hourly Income$ $

Overtime (monthly average) $ $

(if received for past 2 years)

Bonus (monthly average)$ $

(if received for past 2 years)

Commissions (monthly average) $ $

(if received for past 2 years)

OtherIncome (all sources)$ $

TotalIncome$$

Asset Information

Borrower Co-Borrower

Checking Account(s)$$

Savings Account(s)$$

Mutual Fund(s)$$

Individual Stock(s)$$

401K/IRA (vested amount)$$

403b (vested amount)$$

Other #1 $ $

Other #2 $ $

TotalAssets$$

Refinance Information

Current Home Value$

1st Mortgage Balance$

1st Mortgage Termyears

1st Mortgage Interest Rate %

Fixed or Adjustable

1st Mortgage Monthly Payment$

Pre-Payment Penalty?

2nd Mortgage Balance$

2nd Mortgage Termyears

2nd Mortgage Interest Rate%

Fixed or Adjustable

2nd Mortgage Monthly Payment$

Pre-Payment Penalty?

Was the 2nd Mortgage used to purchase the home?

Length of term you are looking for on new loanyears

Home Owners Insurance$

Real Estate Taxes$

Do you currently escrow?

Any Additional Comments: