Short Application Consumer's Choice Mortgage

Borrower Information

First Name *

Middle name initial

Last Name *

Email *

Social Security Number

Address *

Street Address City State ZIP Code

Date of birth

Phone *

Will there be a co-borrower on this loan? Additional information is required for co-borrowers

No
Spouse
Other

Co-Borrower Information

Co-Borrower First Name *

Co-Borrower Middle name initial

Co-Borrower Last Name *

Co-Borrower Email *

Co-Borrower Social Security Number

Co-Borrower Date of birth

Loan Information

Loan Purpose

Purchase
Refinance

Property Type

Primary Residence
Second Home / Vacation Home
Investment Property

Purchase Price

Amount available for down payment or closing costs (approximately)

Credit Check Authorization

Do you authorize us to pull you and your co-borrower’s credit reports in order to pre-qualify you for a loan? (If so, please provide social security numbers and date of births).

Yes
No

Email

This field is for validation purposes and should be left unchanged.