Sellens Real Estate Lending
Phone 909.797.1024
personal efax: 1.951.742.4732
Loan Application Form
To obtain a quote, please complete as much of this
form as you can.
Please use this form by first printing it, then by
putting a check mark next to the
options that describe your situation or needs. When
you finish, you can fax,
email the form, or call me, and we will discuss
possible loan programs.
If you don't know the answer to a question or it
doesn't apply to you, just skip
the question, and go on, or say, “Tell you later.”
My goal is to:
Purchase a new home.
Use the equity in your home thru a refinance.
Buy a new home.
The purpose of this inquiry is:
I am looking for a lender and comparing loan programs.
Turned down by another lender now I am looking for a
unique loan.
I found a house that I want to buy, and need a good
fast loan.
I need to close a loan in 30 days or less.
I want a second deed of trust or line of credit.
I am interested in a Reverse Mortgage loan.
I need a construction loan.
I need a manufactured home move-on loan.
I want an investment loan, like a business loan.
Estimated Market Value / Sales Price is
$____________________.
Purpose of loan
I need funds for the purchase.
I need to refinance to obtain a lower interest rate or
payment.
I need some cash out from the equity in my home.
After the payoff(s), and closing costs, I need
$_____________________
cash.
Income Type:
The person making the most income is the Primary
Borrower.
The co-borrower, if any, is the spouse, family member,
or other.
Income Documentation:
Which of these statements fits your best?
My last 30 days pay-stubs will prove my monthly
income.
My last 2 years federal income tax returns will
qualify me for a loan.
My most current 12/24 months bank statements, if
possible.
Property Type:
I live in the State of California.
I live in the State of __________________________.
Subject property zip code:
Owner occupied properties:
I live in the property I want to purchase or borrow
on.
I plan to live there forever or for _____________
years.
Type of home: (more than one statement may apply)
A Single family residence.
A 1-4 Unit dwelling.
An Apartment house, with more than 4 units.
A mobile home, on leased land, in a mobile home park.
A mobile home, on land that I own, The home is not on
a permanent foundation.
A manufactured home, on land that I own, with a 433a
permanent foundation.
My home is a ( ) single wide; ( ) double wide; ( )
triple wide.
The date of manufacture of the mobile/manufactured
home:
The mobile/manufactured home came directly from the
dealer to its present
location.
The mobile/manufactured home, has been installed on a
previous location, and
then moved to its present location.
Property Zoning:
The home has residential zoning only.
“Agriculture” is part of the zoning classification.
The property is zoned Commercial.
New Loan Proposed Amount:
$__________________
Desired Loan Program:
Fixed or Adjustable rate loan:
I want an Interest Only Loan:
Loan Term that I want:
I want the longest loan terms possible, probably 30 or
40 years.
I want a fixed loan payment, so the payment never
adjusts.
I want a 15 year amortized loan, so my home is paid
off sooner.
I want the lowest interest rate, so I want an
adjustable loan.
I prefer a loan that is fixed for at least these
years:
3 5 7 10 15
I just need a short terms loan for a specific reason.
Existing Property Financing Information:
Existing Loans Against the Property:
1st Mortgage Balance:
Monthly Payment:
Interest Rate:
Prepayment Penalty:
Prepayment Penalty will expire on this date:
Loan Due Date (in years):
2nd Mortgage Balance:
Monthly Payment:
Interest Rate:
Prepayment Penalty:
Prepayment Penalty will expire on this date:
2nd Mortgage Loan Due Date (in years):
Other payoffs:
Delinquent Real Estate Taxes:
Income Taxes I want to pay:
Chapter 13 Loan I want to pay off:
Other Debits I want to pay:
Cash to or From the Borrower:
The Total Cash I have for this Purchase is:
I need to receive this much cash when my loan closes:
No cash, but all my Loans and Creditors, will be paid
off.
Credit Information:
My present living situation is:
My Present Living Expense for Rent or House Payment
is:
That Payment amount includes taxes and insurance.
I can prove mortgage or rental payments for the past
12 months.
I paid with Check or Money Order. (not cash)
During the past 12 months I was 30 days or more late
on the mortgage or rent
payment
I had a Notice of Default or Eviction filed within the
past 12 months on: (date)
Bankruptcy or Foreclosure Information:
I had either a Bankruptcy or Foreclosure in the past 7
years.
The Date I filed a Chapter 7 or Chapter 13 Bankruptcy
Petition was:
Date my Chapter 7 Bankruptcy was Discharged or
Dismissed:
Date my Chapter 13 Bankruptcy was Dismissed or
Dismissed:
I am presently in a Chapter 13, and the balance owning
is:
I have paid on my Chapter 13 for _________ years.
My Trustee payments have been late, more than 30 days
My 1st Mortgage Payment has been late, more than 30
days, _____ times in
the past 12 months.
My 2nd Mortgage Payment has been late, more than 30
days, _____ times in
the past 12 months.
Please add any other information you feel is material
to obtaining a loan:
By signing below, I authorize you to run my credit
report, after I give you
enough information to do so.
______________________________________________
Please sign and date
© 2010 Judith Evicci-Sellens. All Rights Reserved.