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Short Loan Application

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Loan Type

   Borrower's Name, Present Address and Contact Information
 First name
 Last name
 Street address e.g. 123 Market St. Apt # 3
 City
 State
 Zip
 Day phone  e.g. 415-123-4556
 Evening phone e.g. 415-123-4556
 Cell phone e.g. 415-123-4556
 Email address 
 The best time to reach me is

   Property Information
 Property Location
 Estimated Property Value $
 Loan Amount Desired $
 Estimated Existing Loan Balance  
1st mortgage 2nd mortgage 3rd mortgage
$ $ $
 Current Monthly payments  
$ $ $
 Current payment includes taxes and insurance ?

   Credit Information
 How is your credit history?
 Comments

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