-Friday, November 21, 2008-
Apply Online
Complete Mortgage Application
Select Your Palladium Representative
Rep Name
Choose One.......
Not Sure
Casey Bambei
Dean Benallo
Peter Doriguzzi
Victoria Martin
J.R. Rick Pfeifer
John Rollins
Antonio Vitale
Jason Willis
Did someone
referr you?If so what is their name?
This is important because our business is largely based on referrals.
Are you working with a Realtor? If so what is their name?
BORROWER INFORMATION
First Name
Last Name
Social Security #
Date of Birth
Co-Borrower (If applicable)
First Name
Last Name
Social Security #
Date of Birth
Home #
Cell #
Email
CURRENT RESIDENCE
Do You Currently
Rent or
Own , For how many years?
Address #1
Address #2
City
State
AL
AK
AZ
AR
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
OR
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Zip
Will the property be sold before the closing of your new home?
Yes
No
Sales Price
Closing Date
EMPLOYMENT INFORMATION
Employer
Years Employed
Title/Position
Gross Mo. Income
Work #
Self-Employed?
Yes
No
Co-Borrower (If applicable)
Employer
Years Employed
Title/Position
Gross Mo. Income
Work #
Self-Employed?
Yes
No
LIABILITIES
Monthly Payment
/
Balance
Current Mortgage
/
Second Mortgage
/
Estimated Monthly Bills*:
*Include Auto(s), Credit Card(s), Child Support, School Loan(s) and other debts you have an obligation to pay.
ASSETS
Checking Balance
Savings Balance
Mutual Funds
Retirement Account
Sale Proceeds
Gift Funds
New Property Information
Do you intend to occupy the property?
Yes
No
Are you a first-time home buyer?
Yes
No
Estimated purchase price?
Estimated Down Payment?
Estimated closing date?
How long will you own this property?
years
Comfortable monthly payment?
Are you concerned about credit?
Yes
No
Please explain why
Other comments?
BY SUBMITTING THIS APPLICATION I GIVE PALLADIUM FINANCIAL SERVICES AND OR PALLADIUM PARTNERS, AUTHORIZATION TO ORDER A CONSUMER CREDIT REPORT AND VERIFY OTHER CREDIT INFORMATION, INCLUDING PAST AND PRESENT MORTGAGE AND LANDLORD REFERENCES. THE INFORMATION 0BTAINED IS ONLY TO BE USED IN THE PROCESSING OF THIS APPLICATION FOR A MORTGAGE LOAN.
This is a secure
online application.
Thank you for taking the time to fill out this application. If you have any questions please contact us.
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