Purchase / Refinance Worksheet
Please fill out the following worksheet as completely as possible.

Borrowers Information:
Name: Co-Borrower:
Corr. Name: Phone:
Address: Day Phone:
City/State/Zip Fax:
Property Information:
Sale Price: Appraised Value
Property Address: Type Of Unit:
City/State/Zip Number of Units:
Borrowers Income:Monthly
Borrower Base: Co-Borrower Base:
Borrower Overtime: Co-Borrower Overtime:
Borrowers Debt:Monthly
Principle & Interest: Taxes:
Other Debt:
Broker Informantion Seller Information
Broker Name: Seller Name:
Broker Phone: Seller Phone:
Broker Address: Appraiser Contact:
City/State/Zip Appraiser Phone:
Attorney InformationPurchaser Attorney InformationSeller
Attorney Name: Attorney Name:
Address: Address:
City/State/Zip City/State/Zip
Phone: Phone:
Comments:



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1-800-796-7524

Licensed Mortgage Banker NYS Banking Department, New Jersey Banking Department, Conn. Banking Department, Florida Banking Department.
1-800-796-7524

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