Welcome to CFG Mortgage!

	We take a personal interest in your loan!

Purchase Refinance Debt Consolidation Other:

Loan Amount: $ FMV: $ Amt. Owed: $

Cash Out ( Yes No ) Original Cost: $

Current Mtg. Holder: Current Rate:

2nd Mortgage Mobile Home Other

BORROWER:

Name:

DOB / AGE:

Soc. Security: - -

Employer:

Time at present Employment.:
(If less than 2 yrs.)

Previous Employer:

Work Phone #: ( ) -

Monthly Income: $

Other Income: $

Rent Own Other

CO-BORROWER:

Name:

DOB / AGE:

Soc. Security: - -

Employer:

Time at present Employment.:
(If less than 2 yrs.)

Previous Employer:

Work Phone #: ( ) -

Monthly Income: $

Other Income: $

Rent Own Other

Present Address:

City: State: Zip:

Home Phone #: ( ) - Other Phone #: ( ) -

(If less than 2 years at residence) Address:

I/we authorize you to provide to CFG Mortgage and to any investor to whom CFG Mortgage may sell my mortgage, 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.