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Loan Program Loan Purpose 30 Year Fixed 15 Year Fixed 5 Yr Balloon 7 Yr Balloon 1/1 ARM 3/1 ARM 5/1 ARM VA 30 Yr FHA 30 Yr FHA ARM PurchaseRefinanceConstr. LoanSee Comments/OtherFHA LoanVA Loan Loan Amount ($) Property Value ($) Estimated Timeframe < 30 Days 30-60 Days 60-90 Days Not Sure 120 Property Information Property Type - Single family Condo Commercial Investment Co-op Mobile Home Multi Family Address Zip Borrower Information First Name Last Name Work Phone Home Phone Email Employment Information Self Employed Years Employed Annual Income($) no yes 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 < $20,000 $20,000-25,000 $25,000-30,000 $30,000-35,000 $35,000-40,000 $40,000-45,000 $45,000-50,000 $50,000-60,000 $60,000-70,000 $70,000-80,000 $80,000-90,000 $90,000-100,000 $100,000-125,000 $125,000-150,000 $150,000-175,000 $175,000-200,000 > 200,000 + Income and Expense Information Monthly Expenses($) Credit History Excellent Good Fair Poor