Secure Refinance Application (651) 552-3681

Borrower Basic Information 

 * = Required Information

Is there a co-borrower? No   Yes  - If yes, co-borrower name 
If yes, co-borrower information can be entered on the next page
but include their assets (checking/savings) on this page.


Your FULL Name (First, MI, Last) *
Email address *
Best Phone # *    Home or Cell
2nd best phone # 
  Home or Cell
* Work Phone #  (REQUIRED for verification of employment)
Current Address *  
  State   Zip  
How long have you lived here  years  months
Do you currently
Old Address
(if at current less than 2 years)
  State  Zip
Did you
  How long did you live there  years  months
Date of Birth (format mo/da/year)  Required
Social Security Number  Required
Estimated Score
   Ever File Bankruptcy? 
   If Yes, How long discharged? Years
  Ever have a foreclosure
  If yes, how long ago years
Marital Status
Years of Schooling
Any dependents?   No  Yes.
   If yes, how many? . Ages 
Are you a Military Vet?

Borrower Employment

  City  State  Zip 
Position/Title with Company
Time with Current Employer  Years  Months
How long in this line of work? Years
Are you self employed?
Former Employer (if less than 2 years with current employer)

 City State Zip
You worked there from when to when mo /yr until mo / yr
Old Income , per 
Former Position/Title 

Contacting You

We usually attempt to contact you between 10:00 AM & 6:00 PM Monday - Friday. 
If we are unable to contact you during this time frame, it could delay your application.
Daytime Contact  at 

Basic New Loan Information

Purpose of loan
Type of Loan (Fixed, ARM, FHA, etc) 
Amortization Term:  10 yr - 30 yr available
Estimate Loan Amount Needed $
Property will be our


Answer the following additional questions:
Your Current Monthly Payment is: $ 
  Does this include escrows? YES   NO
Your Current Interest Rate? %. Current Mortgage Company Name? 
Do you escrow for taxes & Insurance? YES NO
Who owns your mortgage?  Check Fannie Mae   Check Freddie Mac
Current Escrows: Property Taxes $. Homeowners Insurance $ (if known)
About this property? Year purchased? . What was the original cost? $
Today's Estimated Value $
Estimated Remaining Balance $
Do you have PMI on your loan? YES NO 
Have a 2nd Mortgage/Equity Loan?  YES NO   - If yes, how much do you still owe? 
Keep or consolidate 2nd mortgage? Keep Consolidate
How to pay closing costs?

Subject Property Information:

The Home you are refinancing
Same as mailing address?  Yes
If different, list address:
  City   State  Zip

(we lend in MN, WI, and SD only)

Monthly Income:

Gross Monthly Income (Pre-Tax)
Base Income $  per 
Net Rental Income
Other  (Child Support, Social Security, Pension, etc)
Explain Income 

Assets: (Include all Applicants)

(includes checking, savings, stocks, mutual funds, etc.) (Include all Applicants Assets)
Account 1 $ Name of Bank 
Account 2 $ Name of Bank 
Account 3 $ Name of Bank 
All additional accounts $
Stocks and Bonds $ Name of Bank 
401(k)/Retirement $
Net Worth of Businesses Owned $
Automobiles Owned 1 Yr/Make. Estimated Vale $ 
Automobiles Owned 2 Yr/Make. Estimated Vale $ 

Other Liabilities:

Who do you owe? (Include all Applicants debts)

Alimony/Child Support

$ month
All other debts of ALL applicants (car loans, credit cards, student loans, etc) List only minimum required monthly payments
$month.  Total unpaid balance(s) $

Own Other Properties:

Own any other property? Complete below if yes.
First property address  City St  Zip
What is the payment $
Estimated Value $ How much do you owe on it? $
Rental or Second Home Rental   Second Home
  If rental, what is rent? $
Second property address  City St  Zip
Monthly payment $
Estimated value $ How much do you owe on it? $
Rental or Second Home Rental   Second Home
  If rental, what is rent? $
  If more than 2 home, list addition in 'other' space below


A. Are there any outstanding judgments against you?
B. Have you been declared bankrupt within the past 7 years?
C. Have you had property foreclosed upon or given title or deed in lieu thereof in the last 7 years?
D. Are you a party to a lawsuit?
E. Have you directly or indirectly been obliged on any loan which resulted in foreclosure, transfer of title in lieu of foreclosure or judgment?
F. Are you presently delinquent or in default on any Federal debt or any other loan, mortgage, financial obligation, bond, or loan guarantee?
G. Are you obligated to pay alimony, child support, or separate maintenance?
H. Is any part of the down payment borrowed?
I. Are you a co-maker or endorser on a note?
J. Are you a U.S. citizen?
K. Are you a permanent resident alien?
l. Do you intend to occupy the property as your primary residence?
M. Have you had an ownership interest in a property in the last three years?
(1.) What type of property did you own Principle residence (PR), second home (SH), or investment property (IP)?
(2.) How did you hold title to the home - solely by yourself (S), jointly with your spouse (SP), or jointly with another person (O)?


Information for Government Lender Monitoring purposes
The purpose of collecting this information is to help ensure that all applicants are treated fairly, and that the housing needs of the communities and neighborhoods are being fulfilled. For residential mortgage lending, Federal law requires we ask applicants for their demographic information (ethnicity, sex, and race) in order to monitor our compliance with equal credit opportunity, fair housing, and home mortgage disclosure laws. You are not required to provide this information, but are encouraged to do so. You may select one or more designations for ethnicity and or more designations for race. The law provides that we may not discriminate on the basis of this information, or on whether you choose to provide it. However if you choose not to provide the information, and you have made the application in person, Federal regulations require us to note your ethnicity, sex, and race on the basis of visual observation or surname. The law also provides that we may not discriminate on the basis of age or marital status information you provide in this application. If you do not wish to provide some or all of this information, please check below
  I do not wish to answer these questions
Race White
  Black or African American
           Asian Indian Chinese    Japanese   Philipino Korean
            Vietnamese  Other Asian
           If other, enter Example: Hmong, Pakastani, and so on  
  American Indian or Alaska Native
           Name of enrolled or principal tribe
  I do not wish to answer
Ethnicity:  NOT Hispanic or Latino
 Hispanic or Latino
           Mexican   Puerto Rican  Cuban  Other Hispanic or Latino
            If other, enter Example: Argentinian, Columbia, and so on.  
Gender  Male   Female  Do not wish to answer

Other Information:

Please write in any other information you feel is important to us making our decision, or answers to any YES questions in the declarations section.
How did you find out about us   
This help's keep our advertising dollar effective, therefore reducing YOUR closing costs!


Borrowers Certification and Authorization to Release Information and Important Information About Procedures For Opening A New Mortgage Loan Account
By submitting your mortgage application through our Secure Internet connection: I/We have applied for a mortgage loan with Mortgages Unlimited Inc, hereinafter called the lender. In applying for the loan, I/We completed a loan application containing various information on the purpose of the loan, the amount and source of the down payment, employment and income information, and the assets and liabilities. I/We certify that all of the information is true and complete. I/We made no misrepresentations in the loan application or other documents, nor did I/We omit any pertinent information. I/We understand and agree that lender reserves the right to verify the information provided on the application with the employer and/or the financial institution. I/We fully understand that it is a Federal crime punishable by fine or imprisonment, or both, to knowingly make any false statements when applying for this mortgage, as applicable under the provisions of Title 18, United States Code, Section 1014. I/We understand this pre-approval request is not to be construed as a complete application for credit and does not obligate the applicant in any way to lender. If desired, applicant may contact lender at anytime to finalize a formal credit application, and receive a Estimate of all closing costs and disclosures. As part of the application process, lender and the mortgage guaranty insurer (if any), may verify information contained in my/our loan application and in other documents required in connection with the loan, either before the loan is closed or as part of its quality control program. I/We authorize lender, and to any investor to whom lender may sell my mortgage, to obtain any and all information and documentation that they request. Such information includes, but is not limited to, employment history and income; bank, money market and similar account balances; credit history; and copies of income tax returns. I/We authorize lender to obtain a copy of my/our credit report, and to make contact with me/us by mail, phone, cellphone, text message, or Email. Important Information About Procedures For Opening A New Mortgage Loan Account. To help the government fight the funding of terrorism and money laundering activities, Federal Law now requires all financial institutions to obtain, verify, and record information that identifies each person who opens a mortgage loan account. What this means to you: When you open a mortgage loan account, we will ask you for your name, address, date of birth, and other information that will allow us to identify you. We may also ask to see your driver's license or other identifying documents. The information being requested and observed is for compliance with the requirements of Section 326 of the USA Patriot Act of 2001, implementing customer identification and verification requirements. The information in no way will be used in making the credit decision on your completed application.
By submitting, I agree that I have read, and understand the above disclosures.


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