503-723-5982
Our Approach
10 Things You
Need to Know
Loan Basics
Careers
Calculators
Contact Us
Our Office
Apply Now
Foundation Home Realty
Home
Application
Purchase
If purchase, do you have a down payment?
  Yes   No
If you have a down payment is it:
  Saved   Borrowed   Gifted
Dollar Amount of Down Payment: $
Prefer a Zero Down Payment Program? Yes
Refinance
Purpose (check all that apply):
  Rate reduction, no cash out
  Debt consolidation
  Home improvement
  Cash out

Current Loan Balances:
First: Second:
Current Interest Rates:
First: Second:
Subject Property Estimated Value:
Loan Amount Requested:
Would you like to select a specific loan officer?   
Borrower
Personal Information

First Name:
Middle Name:
Last Name:
Married: Yes No
E-Mail Address:
Social Security Number:  Ex. 555-55-5555
Date of Birth:  Ex. MM/DD/YYYY
Home Phone:  Ex. (555) 555-5555
Cellular Phone:  Ex. (555) 555-5555
Work Phone:  Ex. (555) 555-5555
Fax Machine:  Ex. (555) 555-5555
Mailing Address:
Mailing City:
Mailing State:
Mailing Zip:
Property Address:
Property City:
Property State:
Property Zip:
Number of years
at current address:
Rent Own
Employer:
Number of years
with company:
Position:
Gross Monthly Income:
Overtime/Bonus/Comm:


Banking and Investment Accounts
Name of Bank:
Balance:
Savings:
Stock:
401k Balance:
Co-Borrower
Personal Information

First Name:
Middle Name:
Last Name:
Married: Yes No
E-Mail Address:
Social Security Number:  Ex. 555-555-5555
Date of Birth:  Ex. MM/DD/YYYY
Home Phone:  Ex. (555) 555-5555
Cellular Phone:  Ex. (555) 555-5555
Work Phone:  Ex. (555) 555-5555
Fax Machine:  Ex. (555) 555-5555
Mailing Address:
Mailing City:
Mailing State:
Mailing Zip:
Property Address:
Property City:
Property State:
Property Zip:
Number of years
at current address:
Rent Own
Employer:
Number of years
with company:
Position:
Gross Monthly Income:
Overtime/Bonus/Comm:


Banking and Investment Accounts
Name of Bank:
Balance:
Savings:
Stock:
401k Balance:
Declarations Borrower Co-Borrower
Are there any outstanding judgements against you? Yes No
Yes No
Have you been declared bankrupt in the last seven years? Yes No
Yes No
Have you had a property foreclosed on in the last seven years? Yes No
Yes No
Are you party to a lawsuit? Yes No
Yes No
Have you directly or indirectly been obligated on any loan
which resulted in foreclosure, transfer of title in lieu of
foreclosure or judgement?
Yes No
Yes No
Are you presently delinquent or in default on any
Federal Debt or any other loan, mortgage,
financial obligation,bond or loan guarantee?
Yes No
Yes No
Are you obligated to pay alimony, child support or separate maintenance? Yes No
Yes No
Is any part of the down payment borrowed? Yes No
Yes No
Are you the co-maker or endorser on an note? Yes No
Yes No
Are you a US citizen? Yes No Yes No
Are you a permanent resident alien? Yes No
Yes No
Do you intend to occupy the property as your primary residence? Yes No
Yes No
Have you had an ownership in a property in the last three years? Yes No
Yes No
Comments Or Questions
Please review the following disclosure. By submitting this application you are indicating that you agree with all terms described below.
  • The loan requested with be secured by a mortgage or deed of trust on the property described herein;
  • The property will not be used for illegal or prohibited purpose or use;
  • All statements made in this application are made for the purpose of obtaining the loan indicated herein;
  • Verification or reverification of any information contained in the application may be made at any time by the lender, it's agents, successors or assigns, either directly or through a credit reporting agency, from any source named in this application, and the original copy of this application will be retained by the lender, even if the loan is not approved;
  • The Lender, it's agents, successors or assigns will rely on the information contained in the application and I/we have a continuing obligation to amend and/or supplement the information provided in this application if any of the material facts with I/we have represented herein should change prior to closing;
  • The Lender, its agents, successors or assigns make no representations or warranties expressed or implied, to the Borrower(s) regarding the property, the condition of the property, or the value of the property;
  • Authorization is given to THIS LENDER to obtain my/our credit report
Privacy Policy | DeltaNet login



This site is hosted, designed, and copyright © 1994 - 2006 by Delta Media Group, Inc.