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Refinance Application

Borrower Information:

Co-Borrower Information:

First Name Last Name Home Phone Work Phone	SSN E-Mail Date of Birth
Address	State
City	Zip

First Name Last Name Home Phone Work Phone	SSN E-Mail Date of Birth
Address	State
City	Zip

Borrower Information:

Co-Borrower Information:

Applicant Employer

Employer Address

Employer City

Employer State

Employer Zip

Position

Years on Job
Years in same field

Monthly Income Amt.
$

Co-Applicant Employer

Employer Address

Employer City

Employer State

Employer Zip

Position

Years on Job
Years in same field

Monthly Income Amt.
$

Borrower Information:

Co-Borrower Information:

If at job less than two years, complete below:

Applicant Employer

Employer Address

Employer City

Employer State

Employer Zip

Position

Years on Job
Years in same field

Previous Monthly
Income Amt.
$

If at job less than two years, complete below:

Co-Applicant Employer

Employer Address

Employer City

Employer State

Employer Zip

Position

Years on Job
Years in same field

Previous Monthly
Income Amt.
$

Checking and Savings Accounts Financial Institution	Amount $
Account Number
Financial Institution	Amount $
Account Number


Stocks and Bonds (Please Describe)	Amount $
	$
	$





Other Assets (Please Describe)	Amount $
	$
	$
	$

Refinance Questionnaire

ORIGINAL PURCHASE PRICE:
PURCHASE DATE:
ORIGINAL LOAN AMOUNT:
Property Address:
City:

State:
Zip:

CURRENT LOAN AMOUNT:
CURRENT INTEREST RATE:
Current Term (30 yr., 15 yr.)
Do you have a second lien?		Yes No
If yes, please give the amount:

APPROXIMATE VALUE OF HOME:
Approx. Taxes per year:
Approx. Homeowners ins. per yr.
Do you have mortgage insurance?		Yes No
Do you have a prepayment penalty?		Yes No
How long do you plan on living in this home?


Referred By:	*
The best time to contact me
would be:
around:	:
by:

Comments:

* "I authorize E Houston Mortgage to obtain my/our credit report for the purpose of determining credit worthiness. The information that is obtained is strictly confidential. By submitting this electronically, this is to be deemed to be the equivalent of the original."

Houston Home Mortgage