Personal Information Return by email or fax TO Glenna Stethem page 1 of 4

Edit the document directly or print it out and fax back to me or send it by email as an attachment.
email is glenna_fnms@yahoo.com OR call Glenn for the fax number

Name (primary wage earner)		Name (co-borrower)
Current Address		Current Address
City/State		City/State
When did you move there? mm/dd/yy		When did you move there? mm/dd/yy
Home Phone		Home Phone
Work/Cell Phone		Work/Cell Phone
Social Security		Social Security
Birth Date		Birth Date
How is your credit? Do you have any Bankruptcies, foreclosure, collections, judgments?	Do you have any late mortgage or rental payments, if so what?	How is your credit? Do you have any Bankruptcies, foreclosure, collections, judgments?	Do you have any late mortgage or rental payments, if so what?
If refinance, what was the original purchase price and date you bought it?

Work Information TO Glenna Stethem page 2 of 4

Type of employment? W-2 employee, self employed etc…	Type of employment? W-2 employee, self employed etc…
Type of documentation you can provide to prove income? W-2, 1099, tax returns, 1040 tax or even 12-24 months of bank statements (we take an average of total deposits and credits) or none?	Type of documentation you can provide to prove income? W-2, 1099, tax returns, 1040 tax or even 12-24 months of bank statements (we take an average of total deposits and credits) or none?
Employer name, address, phone	Employer name, address, phone
Position	Position
Dates of employment (from mm/dd/yy to mm/dd/yy)	Dates of employment (from mm/dd/yy to mm/dd/yy)
How Long in same type of work?	How Long in same type of work?
Gross Income (before taxes)	Gross Income (before taxes)
If at above company less than 2 years, please provide companies name, address, your position and salary for prior employment going back a total of 2 years from today. (from mm/dd/yy to mm/dd/yy)	If at above company less than 2 years, please provide companies name, address, your position and salary for prior employment going back a total of 2 years from today. (from mm/dd/yy to mm/dd/yy)

Home Information TO Glenna Stethem page 3 of 4

Purchase or Refinance?	Owner occupy or rental?	Type of home? Single family, duplex, townhouse, condo?		Amount of loan requested?
Current monthly payment?	Annual property taxes amount? Annual homeowners insurance amount?	Does your monthly payment include the taxes and insurance?		If purchase, what is the amount of your desired down payment?
If refinance, amount of cash back to you at closing?	If refinance, what is the approx. payoff of your mortgage? 1^st mortgage: 2^nd mortgage:		What type of loan do you desire? 30, 20, 15 year fixed, or 1,3,5,7 year ARM, Interest only, Pick-A-Payment (option arm)?
Describe the property you are either purchasing or refinancing? (if you are purchasing one, and don’t have the property picked out, just write “to be determined”). (( number of bedrooms and bathrooms, style, siding, garage, lot, fenced or not, Rural, city, suburb etc…)
Are there any association fees? If so how much?
Your email address(s)?
Anything else you want me to know?

Account Information TO Glenna Stethem page 4 of 4

Please list all checking and savings account bank names and approximate or average balance:

Do not list account numbers, just names of the bank, type of account and balance.

Please list all 401k, IRA, Roth IRA, Stocks, Bonds, Mutual Funds, ESOP and any other accounts: list the bank names and approximate or average balance: