Customer Questionnaire - Refinance
  Borrower Co-Borrower
Personal Data
 Full name (First Middle Last)
Birthdate
Home Street Address
Home City State Zip State Zip
Mobile Phone
Home Phone
e-mail
How do you think your credit rating is?
What member of our team were you referred to?
Who referred you to us?
Employment
 Current Employer
Type of Employment (W-2, 1099, retired)
Duration with Current employer
Former Employer (if current is < 2 years)
Type of Employment (W-2, 1099, retired)
If less < 2 years, is it the same line of work?
Gross Income
 YTD Average Monthly Income
Last Years Adjusted Gross Income
2 Years Ago Adjusted Gross Income
Other Documented Monthly Income
Debt
 Car Payments (mthly)
School Loans (mthly)
Home Loans - all mortgage loans(mthly)
Credit Cards (minimum mthly)
Child/Spouse Support/ mth
Other Mthly Payments
Refinance
 Conventional / FHA / VA
Primary, 2nd home, Investment
Current Interest Rate
Cashout?   Value Required   Value Required
Is there an exsisting 2nd Trust Deed or an equity line loan?
Do you intent to include the 2nd TD in the refinance?
Any late mortgage payments?
Annual property taxes?
Annual Hazard policy cost?
Is there an exsisting Impound Account (taxes and insurance)?
Include an Impound Account with the new loan?
Properties
 Do you have other property?   # financed?   # financed?
Legal
 Any outstanding judgements?
Declared bankruptcy in the last 7 years?
Party to a lawsuit?
US Citizen?
Permanent Resident Alien?
Additional Information