Dallas Turley- Sr. Mortgage Consultant Ph-602-320-3239

Five Minute Application

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Dallas Turley- Sr. Mortgage Consultant Ph-602-320-3239

Email: Fax- 480-305-6296

Purchase Price / Property Value: $ / Down Payment: 0% 3% 5% 10% 20% Other _____%
BORROWER GENERAL INFORMATION CO-BORROWER
Borrower: / Co-Borrower:
Married / Single / Divorced (Circle One) / Married / Single / Divorced (Circle One)
Date of Birth: Years of School: / Date of Birth: Years of School:
Email Address: / Email Address:
Phone #: Cell#: / Phone #: Cell#:
Social Security #: / Social Security #:
Current Address: / Current Address:
How Long?: Rent / Own (Circle One) / How Long?: Rent / Own (Circle One)
Monthly Housing Expense: $ / Monthly Housing Expense: $
BORROWER EMPLOYMENT AND INCOME HISTORY / CO-BORROWER
Employer Name: / Employer Name:
Employer Address: / Employer Address:
Position / Title: / Position / Title:
How Long? / How Long?
Phone #: / Phone #:
Self Employed: Yes / No (Circle One) / Self Employed: Yes / No (Circle One)
Monthly Income: $ / Monthly Income: $
Previous Employment (If Less Than 2 Years) / Previous Employment (If Less Than 2 Years)
Employer Address: / Employer Address:
Position / Title: / Position / Title:
How Long? / How Long?
Phone #: / Phone #:
Self Employed: Yes / No (Circle One) / Self Employed: Yes / No (Circle One)
Monthly Income: $ / Monthly Income: $
ASSETS
Cash in Banks: $ / Stocks & Bonds: $ / Auto #1 (Year & Make)
401(k) / IRA: $ / Gift Money: $ / Auto #2 (Year & Make)
LIABILITIES (MONTHLY PAYMENTS)
Credit Cards: $ / Alimony: $ / Child Support: $ / Auto Loans: $ / Student Loans: $
SCHEDULE OF REAL ESTATE OWNED
Property Address: / Present Market Value: / Gross Rental Income: / Mortgage Payments: / Insurance, Taxes, Etc:

I / WE AUTHORIZE On Q Financial TO OBTAIN A CONSUMER CREDIT REPORT CONTAINING MY / OUR CREDIT HISTORY.

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BORROWER SIGNATURE DATE CO-BORROWER SIGNATURE DATE