On-Line Application

* Required Fields

Applicants Name*
Home Phone*
Cell Phone*
Email*
SSN
Date of birth
OK to pull credit?	Yes No
Co-Applicants Name
Home Phone
Cell Phone
Email
SSN
Date of birth
Ok to pull credit?	Yes No
Street Address
City
State
Zip
Years at this address
Do you rent or own?	Rent Own
What is your rent?
1st Mortage Balance
Current interest rate
Current Payment
Does this include escrow?	Yes No
2nd Mortgage Balance
Current Interest Rate
Applicant's Employer
Years Employed
Applicants Monthly Income
Is Applicant Self Employeed	Yes No
Co-Applicant's Employer
Years Employed
Co-Applicants Monthly Income
Is Co-Applicant Self Employeed	Yes No
Applicants Credit
Co-Applicants Credit
Loan type you are requesting
Residence Type
Loan Term
Best time to call
Please tell us what you would like to accomplish with this loan. As well as any other info you think we would need

Colorado Springs, CO Phone: (719)362-7732 | Fax: (866)438-1106

Colorado Mortgage Expers