*required fields Branch Name/Number: *Account Executive: Please Select John Cipriano Eric Barrios Frank Trejo Mickey Baisden Jeff Fink William Barrios Rosie Soto Mike Fink Amar Rahim Michael Whatley CARTEL Borrower Information *Borrower Name: *Loan Officer: *Borrower's Address: City: State: Please Select Alabama Alaska Arizona Arkansas California Colorado Connecticut Dist. of Columbia Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip: *Assumed Credit Score: *Borrower's Employment: Please Select Self Employed Wage Earner *Gross Monthly Income: Loan Information *Loan Products: Please Select 2 Year Fixed 5 Year Fixed 7 Year Fixed 10 Year Fixed 15 Year Fixed 20 Year Fixed 30 Year Fixed Neg Amortization, with 1% Start Rate *Loan Amount: *Purchase Price/ Current Value: *Loan Purpose: Please Select Purchase Refinance *Interest Only: Please Select Yes No *Cash Out: Please Select Yes No How Much Cash Out: *Occupancy: Please Select Owner Occupied 2nd Home Rental *Property Type: Please Select Family Condo Mfg Home *Income Document Type: Please Select Stated Full Doc No Doc Number of Units: *Borrower's Total Cash Reserves:     1st Time Home Buyer: Please Select Yes No Bankruptcy/ Foreclosure: Please Select Yes No Is a Second Equity Loan Need: Please Select Yes No How Much: *Email *Phone Number: Fax Number: NOTES Would you like your account rep to contact your client? Please Select Yes No