Vision Mortgage Online Application

Please provide the following information. All required fields are displayed in Red. If you would like a Loan Officer to review your credit before contacting you, please complete the fields in Blue.

Primary borrower Information

First Name		Last Name
Email		Address
City		State	Alabama Alaska Arkansas Arizona California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Iowa Idaho Illinois Indiana Kansas Kentucky Louisiana Massachusetts Maine Maryland Michigan Minnesota Mississippi Missouri Montana Nebraska North Carolina North Dakota Nevada New Hampshire New Jersey New Mexico New York Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Virginia Vermont Washington Wisconsin West Virginia Wyoming
Zip		Home Phone
Business Phone		Cell Phone
Birth Date (mm/dd/yyyy)		SSN
co-borrower information
First Name		Last Name
Phone		Business Phone
Address		City
State	Alabama Alaska Arkansas Arizona California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Iowa Idaho Illinois Indiana Kansas Kentucky Louisiana Massachusetts Maine Maryland Michigan Minnesota Mississippi Missouri Montana Nebraska North Carolina North Dakota Nevada New Hampshire New Jersey New Mexico New York Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Virginia Vermont Washington Wisconsin West Virginia Wyoming	Zip
Email		Cell Phone
Birth Date		SSN
loan information
Current Mortgage Company
Current Loan Amount
Current Payments
Is Tax Included in this amount		Select Yes No
Current Rate
Type of Current Loan		Select Fixed ARM
I am interested in:		Select One Paying off bills Refinancing an existing loan Doing home improvements Getting additional cash Purchasing a home
Employer
Monthly Income
Type of Loan Desired		Select One Purchase Refinance Equity Line of Credit Second Mortgage
How long with Current Employer
How long at Current Address
Have you declared bankruptcy in the last 7 years?			Select One No Yes
Have you had a foreclosure in the last 7 years?			Select One No Yes
Are you a US Citizen	Yes No	Offer Code
Comments

• Last 2 years w2’s
• Last 30 days Pay stubs, Liens, Award letter
• If self Employed last two years Business License
• Copy of home owners insurance policy
• If declared bankrupt in last 3 years we will need copy of the bankruptcy papers along with discharge letter
• Copy of Drivers License or Government ID
• Last two Most Recent Bank statements