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    EXPRESS APPLICATION ( E-mail to help@cpasy.com ) or
Fax to 914-244-0088 along with a copy of W-2's, Schedule C, first 2 pages of IRS form 1040 for  
  prior two years and  last three months check stubs.        
  Interest Rate Requested ****        % 60-Day Rate Lock Yes (  X    ) No(       )
                           ****      Rates change daily, please contact us for today's rate.
Instructions:          
1. Use this form to request mortgage information.      
2. Items indicated with an asterisk must be filled in.      
General Information:          
    Borrower     Co-Borrower (if different)
Full name: *      
Current Street Address: *      
City, State And Zip: *      
County        
Home Phone: *      
Work Phone      
Social Security Number: *      
Employers      
Position: *      
Self-Employed? * Yes No   Yes    ◊ No     ◊ Leave blank
Length of Employment: *          
Adjusted Gross Monthly Income:*      
Total Liquid Asset: *      
Date of Birth:      
Credit History is: * excellent     excellent  
  Balances due: good, but some lates   good, but some lates
      Credit cards$ __________ some credit problems   some credit problems
      School loans $__________ major credit problems   major credit problems
      Car loans $ ____________ don't know   don't know  
      Other major loans$_______   <<<<Type_____________   leave blank  
Loan request:          
Amount Requested: *  $_________________ Estimated property value $____________  
Type of Loan: * Purchase        
    Refinance        
    Cash Out Refinance      
    Second Mortgage      
    Equity Loan      
    Credit Line      
    Other        
   Closing costs: Are they to be added to the loan  (    )Yes  (    ) No  
Loan Term: * 30 Year Fixed      
    15 Year Fixed      
    10 Year Fixed      
    5/1        
    3/1        
    1 Year Term      
    1 Month Term      
If purchase, down payment will come from: * Gift Savings/Checking Stock 401(k)/IRA Leave Blank
Property Information:          
This information needs to be filled out for property that is collateral for the loan
Property Type - Co-op        
    - Condo        
    - Single family      
    - 2 Family        
    - 3-4 Family      
    - Commercial      
    - Mixed Use      
Street Address    
City, State and Zip Code    
County      
Property will be used for:  - Primary        
    - Second        
    - Vacation        
    - Investment