US Mortgage Capital Associates
 
Free Refinance Program Guarantee
  New Home Mortgage Inquiry
What type of home are you purchasing?  
What is the price of your new home? (e.g. 123000)   $
How much will you be putting down?   $
Have you already found a home?  
Yes No
If yes, have you signed a purchase contract?  
Yes No
What is your estimated purchase date?  
     
What type of loan are you looking for?  
What are the annual property taxes:   $ 
What is the annual insurance:   $ 
Do you want to pay points in exchange for a lower rate?  
Yes No
How many points do you want to pay in exchange for a lower rate?  
Do you want to include your taxes in your mortgage payment? (If no, escrow wavier fee of .25pt will apply)  
Yes No
If you do not currently own a home, skip down to next section.
Do you currently own a home?  
Yes No
What is the estimated value of your home?   $ 
What is the total amount that you owe on your 1st & 2nd mortgages?   $ 
Will you be selling your current home in order to purchase a new home?  
Yes No
Are you currently working with a realtor to:  
The following questions must be answered by all applicants.
What is your household's
GROSS Annual income?
(Include commissions, bonuses
& child support.) 		  $ 
Please list all TOTAL credit card debt.   $ 
Please list all MINIMUM monthly debt payments.
What Do I Include?		   $ 
Can you verify your income with paystubs and/or tax returns?  
Yes No

Please estimate your credit score (450-850):

  
Have you had a foreclosure or filed bankruptcy in the last 7 yrs?  
Have you had any tax liens or judgements against you or your property in the last 7 yrs?  
Borrower Information
First Name  
Last Name  
Your E-mail address  
Address  
City, State, Zip Code  
     
Work Phone Number  
    ext. 
Home Phone Number  
Mobile Phone Number  
Social Security Number
(Optional) 		 
How long have you been at
your current job?		  
Are you self employed?  
Yes No
What is the Best Time for Lenders to contact you?  
Co-Borrower Information
Co-borrower's First Name  
Co-borrower's Last Name  
Co-borrower's
Social Security Number
(Optional) 		 
Select the statement that best describes what you need from our service:
  I need a loan - find me a few lenders so that I can compare my options
  I am working with another lender but have not locked in my rate yet. I am interested
  I have already locked in a rate with another lender and I am just researching other options
  
     
 
 
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