Merchants Home Loan - HUD approved mortgage lender in San Diego, California, Dallas, Texas, and Phoenix, Arizona

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Merchants Home Loan - HUD approved mortgage lender in San Diego, California, Dallas, Texas, and Phoenix, Arizona

1. Borrower and Co-Borrower Information


		Borrower Information	Co-Borrower Information
	First Name :
	Middle Initial :
	Last Name :
	SSN :
	Home Phone :
	Cell Phone :
	Work Phone :
	Email :
	Date of Birth (mm-dd-yyyy):
	Current Residence :	Rent Own Rent Free	Rent Own Rent Free
	Number of Years :
	Number of Months :
	Address :
	City :
	State :
	Zip Code :

If residing at current address for less than two years, please complete the following:

	Former Residence :	Rent Own Rent Free	Rent Own Rent Free
	Number of Years :
	Number of Months :
	Address :
	City :
	State :
	Zip Code :

2. Subject Property Information

	Use Current Address :	Yes
	Property Type :
	Occupancy :
	Address* :
	City* :
	State :
	Zip Code * :
	County* :

3. Loan Information

	Loan Program (receive up to 3 quotes) :


	Loan Purpose :
	Loan Amount*($ ) :
	Down Payment($) :
	Property Value*($) :
	How would you rate your credit? :
	Have you found a home?	Yes No
	Would you like a loan officer to contact you? :	Yes No
	When is the best time to contact you? :
	Would you like to receive emailed rate quotes? :	Yes No