MORTGAGE APPLICATION
1) Amount Applying For:
2) Current 1st Mortgage Balance:  Monthly Payment:  Rate of Interest:
3) Current 2nd Mortgage Balance:  Monthly Payment:  Rate of Interest:
4) Does Mortgage Payment Include Taxes & Insurance?  Yes  No
5) Real Estate Taxes Per Year:
6) Homeowners Insruance Per Year:
7) Current Home Value:
8) Year Home Purchased:  Purchase Price:
9) Amount of Existing Liens:
10) # of Units:Single   Two   Three   Four
BORROWER INFORMATION:	CO-BORROWER INFORMATION:
1) Name:	1) Name:
2) Address:	2) Address:
3) Social Security #: -  -	3) Social Security #: -  -
4) Home Phone:	4) Home Phone:
5) Date of Birth: /  /	5) Date of Birth: /  /
6) Present Employer:	6) Present Employer:
7) Years on this Job:	7) Years on this Job:
8) Years Employed in field:	8) Years Employed in field:
9) Position:	9) Position:
10) Business Phone #:	10) Business Phone #:
11) Gross Monthly Income:	11) Gross Monthly Income:
12) Assets      (401k, savings, IRA, etc.)	12) Assets      (401k, savings, IRA, etc.)

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|RI Mortgage Broker Lic.#20041604LB  First Choice Financial Group is a licensed Mortgage Broker in the State of Massachusetts, License Number MB3452. CT First Mortgage Broker Lic.# 13492  CT Second MOrtgage Broker Lic. # 13850  NH Mortgage Broker Lic.# 11065-MBR. "We arrange but do not make loans"