Quick Application
The short form application below puts you directly in touch with me. Simply complete the information below and then press the submit button. I will contact you regarding your loan options at your convenience. For a full 1003 loan application, please click here or you may call me directly at
(310) 798-6015 and I would be happy to send the application to you.
 


SHORT FORM LOAN APPLICATION

Name:

Spouse's Name:


Address:

City:

State: Zip Code:

Phone Number:


E-Mail Address:


Best time to be contacted:
Morning Afternoon Evening

Purpose of Loan:
To purchase a new home.
To refinance an existing home.
Purchase Information
What price range are you looking in?
From to

How much do you have set aside for your home purchase?
Savings: Gift:

If necessary, would you be able to get help from a
co-mortgagor to qualify for a loan?
Yes No
Refinance Information
What is the current market value of your home?


What is the current balance on your mortgage?


Do you have a second or home
equity mortgage on the property?
Yes No
Comments or additional information: