Raincross Financial Services

Customized Mortgage Quote
* Required Information
About This Loan
* Desired Loan Amount:
* Desired Loan Type:

* Timing of Loan:
* Property Use:

About You
Applicant
* First Name:
MI:
* Last Name:
* Self-Employed:	Yes No
* Length:	Years
* Position:
* Monthly Gross: $

* Phone (day):
* Phone (eve):
* E-mail:
Co-Applicant
First Name:
MI:
Last Name:
Self-Employed:	Yes No
Length:	Years
Position:
Monthly Gross: $

* Address:
* City:
* State:
* Zip code:

About the Property
Property Info	Subject Property (if different from above)
Address:
City:
State:
Zip code:
If a Purchase,Please Complete
Purchase price:
Down Payment Amount:
(If a Purchase) Have you found a Property?:	Yes No

If Refinance or Other, Please Complete
Estimated Value:
Property Type:
Balance 1st:
Payment: $
Rate:	%
Fixed:	Yes No Not sure
Are you Impounded:	Yes No
Amount:

Balance 2nd:
Payment:
Rate:	%
Fixed:	Yes No Not sure

Credit History
* Rate your Credit:
* Have you ever filed Bankruptcy:	Yes No
Bankruptcy Type:
Discharged:	ex.(MM / DD / YYYY)
Other Monthly Debts: $

Final Details
* Contact Instructions:
* How did you hear about us:

Comments: