Application Information

Loan Amount:

Type of Loan:

Purchase
Refinance
Primary Residence
Second Home
Income Property

If Refinancing Answer the following

What is your Current Rate?:
Current Monthly Payment (excluding taxes):
Annual Property Taxes:
Do you currently have Mortgage Insurance?: Yes No
Do you have a Second Mortgage or a line of credit on the Subject Property?: Yes No

• If yes, enter outstanding balance:
• Do you want to keep this loan or consolidate it with the first mortgage? Keep Consolidate

Customer Information

Name:
E-mail:
Current Street Address:
City:
State:
Zip Code:
Home Phone:
Work Phone: include extension if applicable

Property Information

Property Address:
Property City:
Property State:
Property Zip Code:

Property Type:

Single Family
Condo/Townhouse/Multiple Family
Hotel/Condo

Will you occupy the property (either as vacation home or principal home)?:

Yes No

Credit Information

How would you rate your Credit?
Excellent Good Fair Poor

Employment Status
Salaried Self Employed

Employer:
Number of years with Company:
Gross Monthly Income:
Liquid Assets: include checking, savings, stocks, mutual funds etc.

Retirement and 401k:
Monthly Auto Payments:
Credit Card Debt:
How did you hear about Minnesota Mortgage Connection?

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