Eau Claire, Menomonie, Rice Lake mortgage solutions - Mid America Loan Arranger

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Wisconsin mortgage about mid america loan arranger

Please complete the following form and we will be able to provide you with
the information on the loan terms for which you qualify. Thank you!

LOAN INFORMATION...

Requested Loan Amount:

Years Mortgage Term Requested for:

Purpose of Loan:

Purchase
Construction
Refinance
Construction - Permanent
Other (list reason below)

Other:

Property will be:

Primary Residence
Secondary Residence
Refinance
Investment

APPLICANT INFORMATION...

Applicant's Full Name:

Applicant's Age:

Co-Applicant's Full Name:

Co-Applicant's Age:

Address:

City:

State:

Zip Code:

Country:

Home Phone:

Work Phone:

Email:

OTHER INFORMATION WE NEED...

Applicant's Social Security #:

Co-applicant's Social Security #:

Current Residence:

Own
Rent

Applicant's Marital Status:

Married
Single
Divorced
Widowed

Co-Applicant's Marital Status:

Married
Single
Divorced
Widowed

Name, address, and Phone number of current employer:

Number of Years with Above Listed Employer:

Applicant's Monthly Gross Income:

Co-Applicant's Monthly Gross Income:

Downpayment Amount:

Present 1st and 2nd mortgage payments:

List current account balances for checking, savings, investment, retirement, etc:

List make, year and value of automobiles, boats, etc:

DECLARATIONS...

APPLICANT

COAPPLICANT

Are there any outstanding judgements against you?

Yes No

Have you been declared bankrupt in the past 7 years?

Yes No

Have you had property foreclosed upon or given title or deed in lieu thereof in the last 7 years?

Yes No

Are you a party to a lawsuit?

Yes No

Have you directly or indirectly been obligated on any loan which resulted in foreclosure, or judgement? (This would include such loans as home mortgage loans, SBA loans, home improvement loans, educational loans, manufactured (mobile) home loans, any mortgage, financial obligation, bond, or loan guarantee. If "Yes", provide details below in "declarations other info" box, including date, name and address of Lender,, FHA, or VA case number, if any, and reasons for the action.)

Yes No

Are you presently delinquent or in default on any Federal debt or any other loan, mortgage, financial obligation bond, or loan guarantee? If "yes" give details as described and in the same location below as in the preceding question.

Yes No

Are you obligated to pay alimony, child support, or separate maintenance?

Yes No

Is any part of the down payment borrowed?

Yes No

Are you a co-maker or endorser on a note?

Yes No

Are you a U.S. citizen?

Yes No

Are you a permanent resident alien?

Yes No

Do you intend to occupy the property as your primary residence? If yes, complete the next question please.

Yes No

Have you had an ownership in a property in the last three years? If yes, please complete the following two questions.

Yes No

What type of property did you own?
Principle Residence: PR
Second Home: SH
or Investment Property: IP

How did you hold title to the property?
Soley by Yourself: S
Jointly with your Spouse: SP
or Jointly with another person: O

Declarations Other Information as requested above:

NOTICE: By submitting this form I/We understand that this form is for pre-qualification only and is not an application. I/We authorize Mid America Loan Arranger L.L.C. to obtain a credit report on all borrowers named herein and to share that information with my Realtor(s) regarding mortgage pre-qualification.

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