Online Loan Application

To find out how easy it is to use the equity in your home work for you and refinance your home, simply fill out our online loan application below telling us your information. Upon submittal, your loan application wil be forwarded DIRECTLY to Fred Terry who will find the mortgage product that offers the best combination of features, options and rates to suit your requirements. You will be contacted within a very short time frame.

The information you provide is strictly confidential and will be used only to assist us in finding the best refinance package for you! This is a free analysis and you are under no obligation.

While the information you submit here is sent directly to Fred, you may also opt print and fill out this form and fax to Fred at: (757)257-0205

APPLICATION FOR MORTGAGE REFINANCE - ATTN: FRED TERRY

 

YOUR E-MAIL ADDRESS (VERY IMPORTANT)

PURPOSE FOR LOAN

 Bill Consolidation
 Home Improvements
 Refinance 1st & 2nd

RESIDENCY STATUS

 Primary Residence
 Second Home
 Rental Property

CURRENT PROPERTY TYPE

 Single Family   Townhome  Condo   2-4 Family

BORROWER PERSONAL INFORMATION

BORROWER NAME

ADDRESS YEARS AT ADDRESS

CITY

ZIP

HOME PHONE

CELL PHONE/PAGER

DATE OF BIRTH

SOCIAL SECURITY NUMBER

NUMBER OF DEPENDANTS

MARITAL STATUS

 Single
 Married
 Divorced

CO-BORROWER PERSONAL INFORMATION

BORROWER NAME

ADDRESS   YEARS AT ADDRESS

CITY

 

ZIP

HOME PHONE

CELL PHONE/PAGER

DATE OF BIRTH

SOCIAL SECURITY NUMBER

NUMBER OF DEPENDANTS

MARITAL STATUS

 Single
 Married
 Divorced

EMPLOYMENT INFORMATION

EMPLOYER NAME

SELF EMPLOYED?

 Yes
 No

WORK PHONE

POSITION

YEARS EMPLOYED AT THIS JOB

GROSS INCOME (BEFORE TAXES)

 Monthly
 Yearly

EMPLOYMENT INFORMATION (CO-BORROWER)

EMPLOYER NAME

SELF EMPLOYED?

 Yes
 No

WORK PHONE

POSITION

YEARS EMPLOYED AT THIS JOB

GROSS INCOME (BEFORE TAXES)

 Monthly
 Yearly

CURRENT MORTGAGE INFORMATION

CURRENT MORTGAGE COMPANY

PRESENT BALANCE

MONTHLY PAYMENT

TAXES AND INSURANCE?

 Yes
 No

RATE

 Fixed
 ARM

TERM

ESTIMATED PROPERTY VALUE

2nd MORTGAGE INFORMATION

MORTGAGE COMPANY

PRESENT BALANCE

RATE

MONTHLY PAYMENT

TERM

DO YOU OWN OTHER REAL ESTATE?

 Yes
 No

 

PLEASE CHECK ALL THAT APPLY

BORROWER

CO-BORROWER

 Pay Child Support/Alimony
 Declared Bankruptcy?
 Foreclosure?
 Repossession?
 Judgments?
 Are you NOT a US Citizen?

 Pay Child Support/Alimony
 Declared Bankruptcy?
 Foreclosure?
 Repossession?
 Judgments?
 Are you NOT a US Citizen?


 
©2006 Terry Mortgage Group