shortform application
BORROWER INFORMATION (Required information fields appear in bold)
First Name
M.I.
Last Name
Social Security Number
- -
Date of Birth (MM/DD/YYYY)
/ /
Street
City
State
Zip
Own or Rent

How Long?

Do You Own any Other Real Estate?
Best Phone to Contact You At
- -
Best Time to Call



Email Address

Total Gross Yearly Income (Income Before Taxes)
$
How Are You Paid?
Are you obligated to pay child support/alimony? If so, please enter the monthly amount.
$
Current Employer

Current Position
Number of Months
CO-BORROWER INFORMATION (if applicable)

Co-borrower's First Name

M.I.
Co-borrower's Last Name
Social Security Number
- -
Date of Birth (MM/DD/YYYY)
/ /
Street
City
State
Zip
Best Phone to Contact You At
- -
Best Time to Call



Email Address
Total Gross Yearly Income (Income Before Taxes)
$
How Are You Paid?
Are you obligated to pay child support/alimony? If so, please enter the monthly amount.
$
Current Employer

Current Position
Number of Months
REFERRAL INFORMATION
Referred By/How Did You Learn About AJM Mortgage?

LOAN INFORMATION

Loan Purpose

Preferred Loan Type (if applicable)
Property Type
Purchase Price
$
Max Dollar Amount Available for Down Payment and/or Closing Costs
$
If you don't have a specific property in mind to purchase, what is your maximum payment desired (Principal, interest, taxes & insurance)? If you do have a specific property in mind, please list the property address in the comments section below along with any other pertinent information.
$

Do you authorize us to pull your credit report and your co-borrower’s credit reports in order to pre-qualify you for a loan? (If so, please provide social security numbers and date(s) of birth).

Yes   No


COMMENTS