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Form
4 Name:_________________________________________________________
Address: ___________________________________________________________________ Wk #: _____________________ Hm #: _____________________ Cell #: _____________________ Purchase Price: $ _________________________ Current Value: $ _________________________ Date of purchase or last loan: _______________ Original Amount on current loan: $ _____________________ Current Balance $_______________ Interest Rate ________% Original amortization ___________ yrs. Current monthly Payment $____________ Principal & Interest $____________ Monthly Escrow $___________ ***** (Fax current mortgage statement showing above information) ***** Type of loan: Fixed Rate / ARM ? Balloon Prepayment penalty : Y / N Purpose of this refinance: Rate/Term Cash out (home equity) Other: _________________ Amortization of new loan: 15 / 30 Other: ______________________ Currently escrow taxes and insurance: Y / N Escrow with new loan: Y / N Annual taxes: $ _____________________ Home
Ins.:$___________________ Flood:$____________________ Have there been any changes in your credit,
income, job, marital status, a home improvement or home equity loan,
etc...since your last
loan? This is my authorization to Stockstill & Associates to run a personal credit check on me(us). Buyer Full Name: ___________________________________________ SS#: _________________________________________ Co-Buyer Full Name: _________________________________________ SS#: _________________________________________ Loan Officer:__________________________Ph:#____________________Fax:___________________ When Completed FAX
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