Premier Mortgage Services





























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Fill out the application below to initiate the loan process. After completion of the application please press Send Application at the end of form.

We will try to respond to you as soon as possible. The more information we have the better we can discuss your specific options.

Loan Information

Loan Amount: *
Sales Price (if purchase) / Value of Home (if refinance) *

Type of Loan: * Purchase Refinance Second Mortgage

Occupancy Status: * Primary Residence Second Home Investment Property

Property Type: * Single Family Townhouse Multiple Family (2-4 units

Customer Information

Name: *
E-mail: *
Current Street Address:
City:
State: *
Zip Code: *
Home Phone:
Work Phone: include extension if applicable

Credit and Income Information

How would you rate your Credit? * Excellent Good Average Fair Poor

Employment Status Salaried Self Employed

Employer:
Number of years with Company:
Gross Monthly Income:
Liquid Assets: include checking, savings, publicly traded stocks, mutual funds etc.
Retirement and 401k:
Monthly Auto Payments
Monthly Credit Card Debt:
Monthly Debt other than Home, Auto or Credit Card:

Property Information

Property Address:
Property City:
Property State:
Property Zip Code:
Name of condo project if applicable:

If refinancing please answer the following:

What is your Current Balance?
What is your Current Rate?
Current Monthly Payment (excluding taxes and insurance):
Annual Property Taxes:
Annual Insurance:

Do you currently have Mortgage Insurance?:
Yes No
Do you have a line of credit on the Subject Property?:
Yes No
    If yes, enter outstanding balance:
    If yes, have you withdrawn from this account in the last 12 months?: Yes No
Do you have a second mortgage on the Subject Property?:
Yes No
    If yes, enter outstanding balance:
Do you want to keep this loan or consolidate it with the first mortgage?

Questions, Comments, and Details of your specific Loan Scenario.

Thank you. Someone will contact you shortly and discuss your options.