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Your Name, First and Last

Your Email

Your Preferred Phone Number

Is There A Co-Borrower?
—Please choose an option—YesNoUnsure/Other

If Yes, What is your relationship?

Co-Borrower Name, First and Last

Co-Borrower Email

Co-Borrower Phone Number

Your Current Address:

Do you Rent or Own?
—Please choose an option—RentOwn
If you rent, what is your monthly rent?

How long have you rented?

Estimated Credit Score

Down Payment Range:

Liquid Assets: (please list, generally, your liquid assets here)

Non-Liquid Assets: (please list your non-liquid assets here)

Comfortable Monthly Payment Amount:

Marital Status:
—Please choose an option—SingleMarried
Number of Dependents and Ages

Employment Information (Needed for all Borrowers)
Borrower Employer Name:

Borrower Employer Address

Borrower Employer Phone Number

Borrower Position

Borrower Start Date

Borrower How long in this position?

Borrower Approximate Monthly or Annual Income:

Borrower Self-Employed?
—Please choose an option—YesNo
Co-Borrower Employer Name:

Co-Borrower Employer Address

Co-Borrower Employer Phone Number

Co-Borrower Position

Co-Borrower Start Date

Co-Borrower How long in this position?

Co-Borrower Approximate Monthly or Annual Income:

Co-Borrower Self-Employed?
—Please choose an option—YesNo
Debt: How Much Total Debt and/or Monthly Obligations, IF KNOWN, Do You Have?

Do You Own Any Other Real Estate?
—Please choose an option—YesNo
How Did You Hear About The Mortgage Mama?