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WELCOME
Thank you for filling out the application. A Loan Officer will contact you regarding your loan.
NLC Application No.:
Quick Application
Agent Ref. # :
1° Borrower Information
(Fill Out Completely - Please Print)
First Name :
*
Middle Name :
Last Name :
*
SSN :
*
DOB(mm/dd/yyy) :
*
Home Phone :
*
Current Home Address :
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
Distric of Columbia
West Virginia
Wisconsin
Wyoming
Alberta
Ontario
British Columbia
Puerto Rico
Guam
Pacific Island
Virgin Islands
*
Zip :
*
Type
Own
Rent
No of Years :
Monthly Rent $ :
Employer Name :
*
Self Employed :
Yes
Work Phone :
*
Employer Address :
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
Distric of Columbia
West Virginia
Wisconsin
Wyoming
Alberta
Ontario
British Columbia
Puerto Rico
Guam
Pacific Island
Virgin Islands
*
Zip :
*
Position :
Income $ :
/ Month
*
Yrs. On this job :
(yy.mm)
Yrs. in this line of Work :
(yy.mm)
Marital Status :
Unmarried(includes single, divorced, widowed)
Married
Seperated
*
2° CO BORROWER INFORMATION
First Name :
*
Middle Name :
Last Name :
*
SSN :
*
DOB(mm/dd/yyy) :
*
Current Home Address :
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
Distric of Columbia
West Virginia
Wisconsin
Wyoming
Alberta
Ontario
British Columbia
Puerto Rico
Guam
Pacific Island
Virgin Islands
*
Zip :
*
Employer Name :
*
Self Employed :
Yes
Work Phone :
*
Employer Address :
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
Distric of Columbia
West Virginia
Wisconsin
Wyoming
Alberta
Ontario
British Columbia
Puerto Rico
Guam
Pacific Island
Virgin Islands
*
Zip :
*
Position :
Income $ :
/ Month
*
Yrs. On this job :
(yy.mm)
Yrs. in this line of Work :
(yy.mm)
Marital Status :
Unmarried(includes single, divorced, widowed)
Married
Seperated
*
Relationship With Borrower :
Please Select
Spouse/Joint
Separate,Not Married/Joint
Other/No Relationship
*
Purpose of Loan :
Purchase
Refinance (Cash Out)
Refinance (Rate/Term)
*
Loan Program :
Full Doc.
Stated Income
No Ratio
No Doc.
3° Property Address
Property Address :
*
Country :
United States
Canada
AFGHANISTAN
ÅLAND ISLANDS
ALBANIA
ALGERIA
AMERICAN SAMOA
ANDORRA
ANGOLA
ANGUILLA
ANTARCTICA
ANTIGUA AND BARBUDA
ARGENTINA
ARMENIA
ARUBA
AUSTRALIA
AUSTRIA
AZERBAIJAN
BAHAMAS
BAHRAIN
BANGLADESH
BARBADOS
BELARUS
BELGIUM
BELIZE
BENIN
BERMUDA
BHUTAN
BOLIVIA, PLURINATIONAL STATE OF
BOSNIA AND HERZEGOVINA
BOTSWANA
BOUVET ISLAND
BRAZIL
BRITISH INDIAN OCEAN TERRITORY
BRUNEI DARUSSALAM
BULGARIA
BURKINA FASO
BURUNDI
CAMBODIA
CAMEROON
CAPE VERDE
CAYMAN ISLANDS
CENTRAL AFRICAN REPUBLIC
CHAD
CHILE
CHINA
CHRISTMAS ISLAND
COCOS (KEELING) ISLANDS
COLOMBIA
COMOROS
CONGO
CONGO, THE DEMOCRATIC REPUBLIC OF THE
COOK ISLANDS
COSTA RICA
CÔTE D'IVOIRE
CROATIA
CUBA
CYPRUS
CZECH REPUBLIC
DENMARK
DJIBOUTI
DOMINICA
DOMINICAN REPUBLIC
ECUADOR
EGYPT
EL SALVADOR
EQUATORIAL GUINEA
ERITREA
ESTONIA
ETHIOPIA
FALKLAND ISLANDS (MALVINAS)
FAROE ISLANDS
FIJI
FINLAND
FRANCE
FRENCH GUIANA
FRENCH POLYNESIA
FRENCH SOUTHERN TERRITORIES
GABON
GAMBIA
GEORGIA
GERMANY
GHANA
GIBRALTAR
GREECE
GREENLAND
GRENADA
GUADELOUPE
GUAM
GUATEMALA
GUERNSEY
GUINEA
GUINEA-BISSAU
GUYANA
HAITI
HEARD ISLAND AND MCDONALD ISLANDS
HONDURAS
HONG KONG
HUNGARY
ICELAND
INDIA
INDONESIA
IRAN, ISLAMIC REPUBLIC OF
IRAQ
IRELAND
ISLE OF MAN
ISRAEL
ITALY
JAMAICA
JAPAN
JERSEY
JORDAN
KAZAKHSTAN
KENYA
KIRIBATI
KOREA, DEMOCRATIC PEOPLE'S REPUBLIC OF
KOREA, REPUBLIC OF
KUWAIT
KYRGYZSTAN
LAO PEOPLE'S DEMOCRATIC REPUBLIC
LATVIA
LEBANON
LESOTHO
LIBERIA
LIBYAN ARAB JAMAHIRIYA
LIECHTENSTEIN
LITHUANIA
LUXEMBOURG
MACAO
MACEDONIA, THE FORMER YUGOSLAV REPUBLIC OF
MADAGASCAR
MALAWI
MALAYSIA
MALDIVES
MALI
MALTA
MARSHALL ISLANDS
MARTINIQUE
MAURITANIA
MAURITIUS
MAYOTTE
MEXICO
MICRONESIA, FEDERATED STATES OF
MOLDOVA, REPUBLIC OF
MONACO
MONGOLIA
MONTENEGRO
MONTSERRAT
MOROCCO
MOZAMBIQUE
MYANMAR
NAMIBIA
NAURU
NEPAL
NETHERLANDS
NETHERLANDS ANTILLES
NEW CALEDONIA
NEW ZEALAND
NICARAGUA
NIGER
NIGERIA
NIUE
NORFOLK ISLAND
NORTHERN MARIANA ISLANDS
NORWAY
OMAN
PAKISTAN
PALAU
PALESTINIAN TERRITORY, OCCUPIED
PANAMA
PAPUA NEW GUINEA
PARAGUAY
PERU
PHILIPPINES
PITCAIRN
POLAND
PORTUGAL
PUERTO RICO
QATAR
RÉUNION
ROMANIA
RUSSIAN FEDERATION
RWANDA
SAINT BARTHÉLEMY
SAINT HELENA
SAINT KITTS AND NEVIS
SAINT LUCIA
SAINT MARTIN
SAINT PIERRE AND MIQUELON
SAINT VINCENT AND THE GRENADINES
SAMOA
SAN MARINO
SAO TOME AND PRINCIPE
SAUDI ARABIA
SENEGAL
SERBIA
SEYCHELLES
SIERRA LEONE
SINGAPORE
SLOVAKIA
SLOVENIA
SOLOMON ISLANDS
SOMALIA
SOUTH AFRICA
SOUTH GEORGIA AND THE SOUTH SANDWICH ISLANDS
SPAIN
SRI LANKA
SUDAN
SURINAME
SVALBARD AND JAN MAYEN
SWAZILAND
SWEDEN
SWITZERLAND
SYRIAN ARAB REPUBLIC
TAIWAN, PROVINCE OF CHINA
TAJIKISTAN
TANZANIA, UNITED REPUBLIC OF
THAILAND
TIMOR-LESTE
TOGO
TOKELAU
TONGA
TRINIDAD AND TOBAGO
TUNISIA
TURKEY
TURKMENISTAN
TURKS AND CAICOS ISLANDS
TUVALU
UGANDA
UKRAINE
UNITED ARAB EMIRATES
UNITED KINGDOM
UNITED STATES MINOR OUTLYING ISLANDS
URUGUAY
UZBEKISTAN
VANUATU
VATICAN CITY STATE
VENEZUELA, BOLIVARIAN REPUBLIC OF
VIET NAM
VIRGIN ISLANDS, BRITISH
VIRGIN ISLANDS, U.S.
WALLIS AND FUTUNA
WESTERN SAHARA
YEMEN
ZAMBIA
ZIMBABWE
City - State :
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
Distric of Columbia
West Virginia
Wisconsin
Wyoming
Alberta
Ontario
British Columbia
Puerto Rico
Guam
Pacific Island
Virgin Islands
*
Zip :
*
4° PURCHASE
Occupancy Status :
Primary
Secondary
Investment
No. of Units :
Loan Amount :
*
Purchase price :
*
DownPayment $ :
*
Annual Real Estate Taxes :
/ Month
*
Hazard Insurance :
/ Month
*
PM Insurance $ :
/ Month
5° Refinance
Occupancy Status:
Primary
Secondary
Investment
No. of Units :
Market Value $ $:
*
Present Rate/Term $ $:
%
*
Mortgage Bal. $ :
/ Month
*
Mortgage Payment $ :
*
Annual Real Estate Taxes :
/ Month
*
Hazard Insurance :
/ Month
*
PM Insurance $ :
/ Month
Maintenance Fee (Co op/Condo) $ :
/ Month
6° Desired Loan Terms
Loan Term :
Please Select
30 Year Conventional
15 Year Conventional
10 Year Conventional
30 Year FHA Fixed
30 Year VA Loan
1 Year Arm
3/1 Year Arm
5/1 Year Arm
5 Year Balloon
7 Year Balloon
FHA Arm
Other Loan
7° SOURCE OF FUNDS
Bank Name :
*
A/C. No :
*
Balance $ :
*
Bank Name :
A/C. No :
Balance $ :
Life insurance / 401K / Stocks & Bond / Retirement Fund / Child Support... $ :
Balance $ :
I
/
W
e have reviewed the above information and acknowledge its validity based upon information we currently have. I / We understand that this is a pre-qualified and not a formal application for a loan. If pre-qualification is obtained, a full application will be necessary and subject to full processing, underwriting and receipt and mortgage loan, I / We will receive an official Good Faith Estimate estimating the closing cost within (3) business days of the application, as required by the Real Estate Settlement Procedure Act (RESPA). The Undersigned applicant(s) hereby authorize NLC International to obtain a credit report from credit reporting agencies.
Copyright NLC International
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