Loan Amount Requested (required)




30 year amortization 15 year amortization

Property Address

Estimated value of subject property: 

Purchase Refinance

Primary Residence   Secondary Residence   Investment Property

Co-Borrower Information

Name (required)

Address

City
State AL AK AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY
Zip code

Years at this address:

Phone (required)

E-mail (required)

Social Security number (required)

Age

Job Title

Years on Job

Married?YesNo

Company Name

Address

City
State AL AK AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY
Zipcode

Phone

Company Name

Address

City
State AL AK AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY
Zipcode

Phone

Monthly Salary*

(before taxes)
*If self-employed, use a 2-year average of adjusted gross income

Monthly Salary*

(before taxes)
*If self-employed, use a 2-year average of adjusted gross income

Rent

....

PITI*

*Principal, Interest, Taxes & Insurance

"I hereby authorize Nevada County Mortgage and/or its agents to obtain my/our credit report for the purpose of determining credit eligibility. I understand that the information thus obtained shall be treated as strictly confidential. Once submitted electronically, this form shall be deemed equivalent of the original."
 

To contact us:
Call (530)274-0916
or Email:  shelley@nevadacountymortgage.com