Mortgage Quotation Borrower Co-Borrower SSN# SSN# DOB: DOB: Phone# Alternate Phone# Please fill in your mailling address: Address 1: Address 2 City: State: Zip: Type: Single Family Condo TownHome Bedrooms: Bath: Pool Year Purchsed: Purchase Price: Market value: Year Built: 1st Mortgage Bal: 2nd Mortage Bal: 1st Mortgage Lender Mortgage Payment 2nd Mortgage Lender Mortgage Payment Taxes Insurance Credit Status Excellent Good Average Fair Bad Ever Filed Bankruptcy? Yes No Exployer Employer Job Title Job Title How Long: How Long: Salary: Salary: Address: Address: Phone: Phone: