Legacy Mutual Mortgage

Opening doors to homeownership...Creating Clients For Life!

Complete Application

Bold Fields Are Required

Step 1. Tell us about you.

Borrower Information
Title
First Name
Middle Name
Last Name
Street
City
State
Zip Code
SSN#
Age
Home Phone
Work Phone

Co-Borrower Information (If any)
Title
First Name
Middle Name
Last Name
Street
City
State
Zip Code
SSN#
Age
Home Phone
Work Phone

Step 2. Tell us about your situation.

Property Address

Street
City
State
Zip Code

Number of Units
Occupancy Type
Property Value	$

Mortgage Loan Type
Program Type
Purpose of Loan
If you chose "Refinance" what is the purpose?
If you chose "Other" please explain?

Desired Loan Amount	$
If purchase, what is the estimated purchase price?	$
Estimated Down Payment	$
If refinance, what is the total owed on home?	$
Length of Requested Loan in years:

Step 3. Tell us about your employment.

Borrower Information
Self Employed	Yes No
Employer
How Long(Yrs/Mths)	/
Monthly Income	$
Overtime	$
Bonuses	$
Commissions	$
Other	$

Co-Borrower Information
Self Employed	Yes No
Employer
How Long(Yrs/Mths)	/
Monthly Income	$
Overtime	$
Bonuses	$
Commissions	$
Other	$

Step 4. Tell us about your assets/liabilities.

Borrower Information
Checking	$
Savings	$
Stock	$
401K's/IRA's	$
Auto Loans	$
Other Loans	$
Child Support	$

Co-Borrower Information
Checking	$
Savings	$
Stock	$
401K's/IRA's	$
Auto Loans	$
Other Loans	$
Child Support	$

Other Information

I have found a real estate agent.
Yes No
Agent's Name
Agent's Company
Agent's Phone #
I need a realtor, please contact me.
Yes No

Additional Comments

^*I/We understand that this form is for pre-qualification only and is not an application.

Authorization to check credit verification
Yes No

By selecting "Yes" to this radio button, I/We hereby authorize Legacy Mutual Mortgage to order a consumer credit report to verify credit and other information pertaining to pre-qualification. This information that is obtained is only to be used for mortgage pre-qualification purposes.

Email Address:

How did you find out about us?

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