Intake Form

Who is filling in this form? *

William (Memo) Flores
Brian Landeros
Anthony Reanue
Miguel Contreras
Veronica Contreras
Samara Smith
Brittney Noble
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Primary Borrower Information

First Name

Last Name

Email

Phone

Co-Borrower Information

First Name

Last Name

Email

Phone

Income Information

Marital Status

Married

Common-law married

Separated

Divorced

Widowed

Not married

How Long with Current Employer?

Borrower Income Type

Salary / Wage Earner

Self Employed

Retired

Student

Unemployed

Contractor/Consultant

Co-Borrower Income Type

Salary / Wage Earner

Self Employed

Retired

Student

Unemployed

Contractor/Consultant

Military / Civilian Status

Borrower Military / Civilian Status

Active Duty Service Member

Veteran

Civilian

Surviving Spouse

Co-Borrower Military / Civlian Status

Active Military Service Member

Veteran

Civilian

Surviving Spouse

Loan Information

Have you filed for bankruptcy, or had a short sale or foreclosure in the last 7 years?

Yes

No

Loan Type

VA Loan

Conventional Loan

FHA Loan

Self Employed Loan

Reverse Mortgage

Second Mortgage / HELOC

Private Loan

Other

Transaction Type

Purchase

Rate and Term Refinance

Cash-out Refinance

Renovate a Home

VA Loan Eligibility

Eligible

**Not eligible for VA ( this is a FHA or CONV loan)

Desired Loan Amount

$

Property Information

Dwelling Type

Single-Family Home

Condo

ADU

Mobile Home

Property Type

Attached

Detached

Do You Own Other Properties?

Yes

No

Are You Currently in Forbearance? (If refinance)

Yes

No

Does Your Home Have Solar?

Yes

No

HOA?

Yes

No

Document Checklist

Did your client provide the following documents on the purchase Transaction (select all that apply)

1 Month Pay stubs

2 Recent Years W2’s

1 Full Month Bank Statement

ID

Social Security Card

If self Employed 2 recent years 1040’s/Tax return

Mortgage Statement (All Properties Owned)

Evidence of Homeowners Insurance declarations page (All Properties Owned)

Other Information

Referral Source - Who or where did this loan come from?

The Story - What will cause hiccups in this transaction? What is the compelling case for this loan? etc...

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