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Please complete this brief information request form.  It only takes a few minutes, and there is absolutely no obligation!  All information is kept strictly confidential

* required fields

APPLICANT/CO-APPLICANT INFORMATION
   
*ARE YOU A HOMEOWNER?

 

       
 

 

    
* APPLICANT First
Last 		* E-MAIL (Appl)
CO-APPLICANT First Last E-MAIL (Co-Appl)
* ADDRESS
 
* CITY * STATE
* ZIP    

CONTACT INFORMATION
* HOME PHONE () -
WORK PHONE () - Ext:
* WHAT IS BEST TIME TO CONTACT YOU

LOAN INFORMATION
* TYPE OF LOAN DESIRED
* LOAN AMOUNT DESIRED

PROPERTY INFORMATION
* TYPE OF HOME OWNED
* CURRENT VALUE OF HOME
* ORIGINAL PURCHASE PRICE
* YEAR PURCHASED
* FIRST MORTGAGE BALANCE
* INTEREST RATE
* SECOND MORTGAGE BALANCE
* INTEREST RATE
* MONTHLY PAYMENTS  (Enter 0 if none)
* IF BEHIND ON PAYMENTS (HOW MUCH)
* NUMBER OF TIMES LATE ON MORTGAGE

CREDIT/EMPLOYMENT/INCOME INFORMATION
* HOW WOULD YOU RATE YOUR CREDIT
* PLACE OF EMPLOYMENT
* YEARS THERE
* HOUSEHOLD INCOME
* MONTHLY DEBT (do not include mortgage)  (Enter 0 if none)

COMMENTS

PLEASE ENTER INFORMATION THAT YOU FEEL IS IMPORTANT TO THE LENDERS.

*

 
 
 
 
   
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5950 W. Oakland Park Blvd. Ste. 300 Lauderhill, FL 33313
Phone (954) 677-2443 • Fax (954) 677-8298 • Beeper (954) 896-0024

E-mail: info@starbankfinancial.com