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First Mortgage Information Do you want a fixed or adjustable rate? Fixed Adjustable What rate have you been quoted? If a refinance, what is your present balance? $ What is the fixed rate term of your loan? 30 years 20 years 15 years 10 years 5 years Other What is the monthly payment on this mortgage? $ Does that include taxes and insurance? Yes No What year did you take out this loan?

General Property Information for Refinancing When did you purchase your home? What was the purchase price? $ What is the value of your home? $ What type of property is your home? Single Family Residence Condominium 1-4 units Manufactured home Mobile home Attached home

General Information Are you self-employed? Yes No How long have you been self-employed? Will this be an Income Qualifying or Non-Qualifying loan? Income Qualifying Non-Qualifying What is your yearly salary? $ Is your spouse self-employed? N/A Yes No How long has your spouse been self-employed? What is the best number where we can reach you? (Include an extension, if any) What is the best time for our loan officer to call you? Morning Afternoon Evening Anytime