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Madison First Financial, Inc. - A Nationwide Mortgage Lender
"The Best Mortgage Interest Rates, The Lowest Closing Fees" 		Madison First Financial, Inc. - A Nationwide Mortgage Lender
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QUICK RATE QUOTE:

First Name
Last Name
State
Phone
Email

Policies/Legal Disclosures
Mortgage Loan Application

Personal Information:

BORROWER

Full Name

Address

What is your living status?
Own Rent Live with relatives

How long have you lived here?

How much is your current housing expense?

What type of mortgage do you currently have?

Previous Address (If less than 2 years at current address)

E-Mail Address

Date of Birth

Sex
Male Female

Years of Schooling

Number of Dependents

Ages of Dependents

Marital Status
Married Single Separated

Social Security Number

Home Phone Number

Work Phone Number

Are you a U.S. citizen?
Yes No

If not,do you have a green card?
Yes No

Are you obligated to pay alimony or child support?
Yes No

CO-BORROWER

Full Name

Address

What is your living status?
Own Rent Live with relatives

How long have you lived here?

How much is your current housing expense?

What type of mortgage do you currently have?

Previous Address (If less than 2 years at current address)

E-Mail Address

Date of Birth

Sex
Male Female

Years of Schooling

Number of Dependents

Ages of Dependents

Marital Status
Married Single Separated

Social Security Number

Home Phone Number

Work Phone Number

Are you a U.S. citizen?
Yes No

If not,do you have a green card?
Yes No

Are you obligated to pay alimony or child support?
Yes No

The following information is requested by the Federal Government in order to monitor the lender's compliance with Equal Credit Opportunity, Fair Housing and Home Mortgage Disclosure Laws. The law provides that a lender may not discriminate on the basis of this information.

BORROWER

Race/National Origin
White, not of Hispanic origin
American Indian
Alaska Native
Black, not of Hispanic origin
Hispanic
Asian or Pacific Islander

CO-BORROWER

Race/National Origin
White, not of Hispanic origin
American Indian
Alaska Native
Black, not of Hispanic origin
Hispanic
Asian or Pacific Islander

Property Information

Address of Property being Purchased

Sale Price

Annual Taxes

Has the seller accepted the contract? Yes No

Is the Property... single family? duplex? triplex?

Will you use the property as... primary residence? vacation home? investment?

Is this property a... condominium? townhome? fee simple home?

Is there an association fee? Yes No

If yes, How much monthly?

Who is the Realtor that helped to complete the contract?
Company and Address

Agent

Phone number

Who is the Realtor that had listed the property for sale?

Company and Address

Agent

Phone Number

Employment Information:

Borrower's Employer's Name & Address:

Position

How long employed here?

Gross Monthly Salary

Click the button if Self-Employed

 Co-Borrower's Employer's Name & Address:

Position

How long employed here?

Gross Monthly Salary

Click the button if Self-Employed

Please complete this section if you have been with your current employer for less than 2 years:

Borrower's Previous Employer Name & Address:

Position

Dates employed here
to

Gross Monthly Salary

Click the button if Self-Employed

 Co-Borrower's Previous Employer Name & Address:

Position

Dates employed here
to

Gross Monthly Salary

Click the button if Self-Employed

Please complete this section for a 2nd job or additional employers.

Borrower's Second Employer Name & Address:

Position

Dates employed here
to

Gross Monthly Salary

Click the button if Self-Employed

 Co-Borrower's Second Employer Name & Address:

Position

Dates employed here
to

Gross Monthly Salary

Click the button if Self-Employed

Asset Information:

For this section, please only give approximate figures in each account area. There is no need to give account numbers in which the monies reside.

Savings
Institution

Checking
Institution

Money Markets
Institution

401K Plans
Institution

Mutual Funds
Institution

Stocks & Bonds
Institution

Any other liquid assets you feel are applicable:

Are any of the above stated funds not to be used for purchase of new real estate:

Do you have any potential gift monies coming from a family member?
YES
NO

What is their relationship to you?

If YES, what would the amount be?

Debt Information:

The following debt information is a critical aspect of this financial analysis. We will give you several general categories of possible revolving debt to fill in. These may not be all-inclusive, so please use the 'other' section to include your unique situation. Revolving debt is defined as any constant, monthly payments you make. (ie: car payments, home equity loan, school loans, credit cards...)

Please give both the current total balance of the debt as well as the current monthly payment.

Combined Credit Cards:
Approximate Balance
Monthly Payment

Car Loan #1:
Approximate Balance
Monthly Payment

Car Loan #2:
Approximate Balance
Monthly Payment

School Loan #1:
Approximate Balance
Monthly Payment

School Loan #2:
Approximate Balance
Monthly Payment

Personal Loans:
Approximate Balance
Monthly Payment

1st Mortgage:
Approximate Balance
Monthly Payment

2nd Mortgage:
Approximate Balance
Monthly Payment

Please continue with any other revolving debts you may have that do not fit in the categories listed above:

Have you ever been previously married?
YES
NO

If YES, is there any alimony/child support, and how much on a monthly basis?

How long will payments continue ?

If you currently own will you be selling the property prior to buying the new property?
YES
NO

If you are selling/or will sell this property prior to your new purchase, what will the approx. net proceeds equal?

If you are not selling this property, what will your total monthly cost be to maintain it (ie: loan payments, taxes & Insurance)

If you own a second or third home please give the same info for them in the space provided below:

Disclosure Information:

Will you occupy the new premises?
YES
NO

Have you in the last 7 years declared bankruptcy, suffered foreclosure, had an account assigned for collection or had any legal action affecting your ability to finance?
YES
NO

If, YES, explain below:

Are you a US citizen ?
YES
NO

If NO, are you a US Resident Alien?
YES
NO

Do you have Veteran's status ?
YES
NO

If YES, are you a reservist?
YES
NO

Is any part of the purchase price or settlement cost being obtained from a source other than shown?
YES
NO

If you answered "YES" and the money in question is other than monies mentioned in the gift section above, please describe below:

Mortgage Options

Please complete the following section to indicate your preference for your financing. Your mortgage counselor will be calling you to answer any questions and confirm your selections. At that time you will be given instructions on how to lock in on current interest rates.

How long do you think that you will own the new home that you are financing?
0-5 years
5-10 years
10-15 years
15 or more years

What mortgage term do you prefer?
10 years
15 years
20 years
30 years

How many points are you considering?
None
One
Two
Three

What loan program are you considering?
Fixed
1 year arm
FHA
3/1 year arm
VA
5 or 7 year arm
Buydown
COFI adjustable
5 or 7 year balloon
Other

How much of a loan are you requesting?

Completing this information does not guarantee mortgage approval. This should not be considered an extension of credit. I/We hereby authorize Madison First Financial, Inc. to obtain a credit report in my/our names, for mortgage application purposes only. The RESPA Act prohibits lenders from distributing credit reports to any third party.

Please run my credit
Do Not run my credit

Thank you for taking the time to review and complete this form.
Simply click on the "submit request" button below and someone will contact you shortly.

Thank you.
United States Map Licensed Dept. of Banking
PA, NJ, DE, MD, NH, VA, CT, MA, MI, IL, CO, WY, TN, FL, IN, MN, CA, WI, RI, NY

License Pending
ME, VT, OH, WV, KY, NC, GA, MS, AL, IO, MO, AR, LA, ND, SD, NE, KS, OK, TX, MT, ID, UT, NV, AZ, NM, WA, OR, HI, AK
PAMB United       NAMB National Association of Mortgage Brokers       FHA Approved U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT

Equal Housing Opportunity Equal Housing Lender - All Rights Reserved