ES
LOAS Portal: Refinance Loan
Fill out the form below to request a loan appointment for your client. An experienced, licensed mortgage loan originator will be in touch shortly.
LOAS Refinance EN
Name of Loan Officer
- select -
Enrique Fonseca
Andres Carrillo
Loan Accelerator Name
First Name
Middle Name
Last Name
Phone Number
Email
Date of Birth
Social Security Number or ITIN
Legal Status
Citizen
Resident
Work permit
Non-Resident (ITIN)
When does your residency or work permit expire? (If apply)
What is your marital status?
- Select -
Married
Divorced
Single
Current Address
City
State
Zip Code
How long have you been at this address?
How much is your mortgage?
Have you ever had a late payment on your mortgage?
Yes
No
Do you own any other property/home in the United States?
Yes
No
Address
City
State
Postal Code
How long have you had this home?
How much is your mortgage?
How much do you think your property is worth?
What is your current interest rate on your loan?
Number of Dependents
Dependent Age
Have you filed your last two years of income taxes?
Yes
No
Name of your Employer
Employer's Phone Number
Employer Address
Employer City
Employer State
Employer Zip Code
Start date at job
What is your position or title within the company
Are you paid hourly or salary?
Hourly
Salary
How much do you get paid an hour? (Your Gross income, before deductions)
How much do you get paid in salary? (Your Gross income, before deductions):
xx Does this client have more than 2 years at their current job?
Yes
No
Name of past employer
Employer's phone number
Employer Address
Employer City
Employer State
Employer Zip Code
How long were you at this job? (Be specific with month and year)
What is your position or title within the company
Are you paid hourly or salary?
Hourly
Salary
How much do you get paid an hour? (Your Gross income, before deductions)
How much do you get paid in salary? (Your Gross income, before deductions)
Does the client complete their 2 year history with this job?
Yes
No
Name of past employer
Employer's phone number
Employer Address
Employer City
Employer State
Employer Zip Code
How long were you at this job? (Be specific with month and year)
What is your position or title within the company
Are you paid hourly or salary?
Hourly
Salary
How much do you get paid an hour? (Your Gross income, before deductions)
How much do you get paid in salary? (Your Gross income, before deductions)
Does the client complete their 2 year history with this job?
Yes
No
Do you have another job?
Yes
No
Name of your Employer
Employer's Phone Number
Employer Address
Employer City
Employer State
Employer Zip Code
Start date at job
What is your position or title within the company
Are you paid hourly or salary?
Hourly
Salary
How much do you get paid an hour? (Your Gross income, before deductions)
How much do you get paid in salary? (Your Gross income, before deductions):
Do you receive any other income such as social security, child support, retirement plan, etc?
Yes
No
How much do you pay per month in minimum payments for the debts that appear on your credit? (not including rent)
Do you pay child support or maintenance?
Yes
No
Do you owe money to the government or the IRS?
Yes
No
If you are on a payment plan, how much do you pay per month? (if applicable)
Is someone suing you or is there a lawsuit against you?
Yes
No
Have you filed for bankruptcy?
Yes
No
Have you lost a home?
Yes
No
What is your credit score?
When was the last time I checked it?
Why do you want to refinance (there may be multiple answers)?
To lower your monthly payment and your interest
To cut year off your mortgage or extend your term
To take cash out against my property
To consolidate debt
To make repairs to my home
What interest rate do you currently have?
How much do you owe on your property?
How much do you think your house is worth?
Will you be applying with someone else? (A co-signer)
Yes
No
Previous
Next
Co-borrower's Details
First Name
Middle Name
Last Name
Phone Number
Email
Date of Birth
Social Security Number or ITIN
Legal Status
Citizen
Resident
Work permit
Non-Resident (ITIN)
When does your residency or work permit expire? (If apply)
What is your marital status?
- Select -
Married
Divorced
Single
Current Address
City
State
Zip Code
How long have you been at this address?
How much is your mortgage?
Have you ever had a late payment on your mortgage?
Yes
No
Do you own any other property/home in the United States?
Yes
No
Address
City
State
Postal Code
How long have you had this home?
How much is your mortgage?
How much do you think your property is worth?
What is your current interest rate on your loan?
Number of Dependents
Dependent Age
Have you filed your last two years of income taxes?
Yes
No
Name of your Employer
Employer's Phone Number
Employer Address
Employer City
Employer State
Employer Zip Code
Start date at job
What is your position or title within the company
Are you paid hourly or salary?
Hourly
Salary
How much do you get paid an hour? (Your Gross income, before deductions)
How much do you get paid in salary? (Your Gross income, before deductions):
Does this client have more than 2 years at their current job?
Yes
No
Name of past employer
Employer's phone number
Employer Address
Employer City
Employer State
Employer Zip Code
How long were you at this job? (Be specific with month and year)
What is your position or title within the company
Are you paid hourly or salary?
Hourly
Salary
How much do you get paid an hour? (Your Gross income, before deductions)
How much do you get paid in salary? (Your Gross income, before deductions)
Does the client complete their 2 year history with this job?
Yes
No
Name of past employer
Employer's phone number
Employer Address
Employer City
Employer State
Employer Zip Code
How long were you at this job? (Be specific with month and year)
Are you paid hourly or salary?
Hourly
Salary
How much do you get paid an hour? (Your Gross income, before deductions)
How much do you get paid in salary? (Your Gross income, before deductions)
What is your position or title within the company
Does the client complete their 2 year history with this job?
Yes
No
Do you have another job?
Yes
No
Name of your Employer
Employer's Phone Number
Employer Address
Employer City
Employer State
Employer Zip Code
Start date at job
What is your position or title within the company
Are you paid hourly or salary?
Hourly
Salary
How much do you get paid an hour? (Your Gross income, before deductions)
How much do you get paid in salary? (Your Gross income, before deductions):
Do you receive any other income such as social security, child support, retirement plan, etc?
Yes
No
How much do you pay per month in minimum payments for the debts that appear on your credit? (not including rent)
Do you pay child support or maintenance?
Yes
No
Do you owe money to the government or the IRS?
Yes
No
If you are on a payment plan, how much do you pay per month? (if applicable)
Is someone suing you or is there a lawsuit against you?
Yes
No
Have you filed for bankruptcy?
Yes
No
Have you lost a home?
Yes
No
What is your credit score?
When was the last time I checked it?
Why do you want to refinance (there may be multiple answers)?
To lower your monthly payment and your interest
To cut year off your mortgage or extend your term
To take cash out against my property
To consolidate debt
To make repairs to my home
What interest rate do you currently have?
How much do you owe on your property?
How much do you think your house is worth?
Agent or Company that referred you
Notes
Leave this field empty
Previous
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