Please fill out the following form so that we can begin the borrower application process.  If you have questions about this form, please contact us.  

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Note that items marked with an asterisk(*) are required.

Loan Officer Name*	Please provide us with the name of the Loan Officer you are working with.  If you don't have a Loan Officer, please type "none."
Borrower
Borrower Name*
Social Security Number*
Home Phone*
Work/Cell Phone*
eMail Address
Age*
Years of School*
Co-Borrower
C0-Borrower Name
Social Security Number
Home Phone
Work/Cell Phone
eMail Address
Age*
Years of School*
Other Information
Mailing Address*
City, State, Zip*
How Long at Present Address*	(note, if less than two years, please list previous address)
Previous Address
City, State, Zip
Property Address (if other than mailing)
City, State, Zip
Occupancy Status* Estimated Value*: Property Type*       Purpose of Loan*	Primary Address Second Home Investment Property Single Family Residence Condominium Town Home Other (please explain): Purchase Refinance Other (please explain):
If Purchase	Purchase Price:                   Amount of Down payment:   Source of Down Payment:              Proceeds from Sale of Property     Savings     Other (please explain):
If Refinance	Year Acquired  Original Cost   Amount of Existing Liens
	Purpose of Refinance:              Debt Consolidation     Cash Out (for home improvement,           education, savings, etc.)     Lower rate or shorter term     2nd Mortgage Only
Loan Amount Requesting*
Lien Position	First Second
Loan Type*	(Please choose either a fixed rate or adjustable rate mortgage term (you can't have both):
	Fixed Rate Term 30-Year 20-Year 15-Year 10-Year Interest Only Power Option ARM Adjustable Rate Mortgage 1 Year Arm 3/1 Arm 5/1 Arm 7/1 Arm
Borrower
Borrower Employer*
Years on Job*
Self-employed*	Yes No
Years in this line of work*
Job Title*
Monthly Base Income*
Other income
Source of other income*	Social Security Retirement Child Support Other (please specify):
Co-Borrower
Co-Borrower Employer
Years on Job
Self-employed	Yes No
Years in this line of work
Job Title
Monthly Base income
Other income
Source of other income	Social Security Retirement Child Support Other (please specify):
Do you have a checking account?*	Yes No If yes, balance in account:
Do you have a savings account?*	Yes No If yes, balance in account:
Please list any other accounts below along with balance (ie., 401k, IRA, etc.).  Note that account numbers are not necessary at this time.
Have you ever applied for a loan with us before?	Yes   If yes, when?:  No
Comments
*Note:  All information provided to Colorado First Real Estate and Mortgage, Ltd., must be verifiable. I hereby give Colorado First Real Estate and Mortgage, Ltd. permission to order a consumer credit report and verify other information.