CSI Mortgage Corp. - Borrowers - Online Application

Instructions for Online Application

1. Use this form to send an Online Application to CSI Mortgage Corp.
2. Fill out as much information as possible.
3. Click on the "Click Here to Submit" button at the end of the form.
4. Within a short period of time, you will be contacted by a CSI Mortgage representative.

Please tell us about yourself:

First and Last Name:

Street Address:

City:

State:

Zip Code:

E-Mail Address:

Telephone Number:

Fax Number:

Employment

I am Self Employed

I am NOT Self Employed

Income

My gross monthly income is $ per month.

Monthly Debt

My monthly debt is $ per month.

(Credit Cards, Car Payments, Alimony, Child Support, etc.)

Rent or Mortgage Payment

I currently RENT and pay $ per month.

I have a MORTGAGE and pay $ per month.

How would you rate your credit level:

This is not to disqualify you. We have loan programs to fit any credit level.

Excellent (No late payments)

Good (No lates on Mortgage but 1 or 2 on other Bills)

Fair (1 or 2 Lates on Mortgage and 1 or 2 on other Bills)

Poor (More than 2 lates on Mortgage and Bills)

Bankruptcy or Foreclosure within 5 years

What is your preferred method of contact:

Telephone

E-mail

Fax

Mail

Describe the property you intend to finance:

Property Information

The property must be within the State of Arizona. Sorry, Arizona State Banking Department rules apply.

Property Street:

Property City:

Property State:

What is the type of property:

Single Family Residence

Duplex, Triplex or Fourplex

Condominium

Townhouse

Apartment Building (More than 4 units)

Commercial Building

Land (improved or unimproved)

Describe who occupies the property:

My Primary Residence (I live here)

New Primary Residence (I am purchasing a new home)

Investment Property (I rent it to someone else)

Secondary Residence/Vacation Home

Describe your present debt against the property:

Outstanding Balance

Monthly Payment

Interest Rate

Term of Payments

Describe the value of the property:

Estimated Value

List any additional information about the property you feel is important:

Describe the Loan Programs and Services in which you are interested:

Programs and Services

Preapproval for First-time Home Buyers

New Purchase

Refinance an Existing Loan

Home Equity Loan or Debt Consolidation

Up to 125% LTV Loan

Prequalification

Construction Loans

Fix up a Property for Sale or Profit

Commercial Property Refinance or Purchase

If not listed above, briefly describe your financing need:

All information posted to CSI Mortgage Corp. shall remain strictly confidential. We do not distribute your confidential information to outside sources.

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CSI Mortgage Corp.^tm
9832 N. Hayden Rd., Ste. 213, Scottsdale, AZ 85258
(480) 860-4028

(800) 758-1793

FAX (480) 451-4516
Arizona Mortgage Banker #0906107