Bob Licare

Senior Loan Officer

Quick Loan Application

Entries marked with an asterisk (*) are required
to process your Application.

I'll review your Application and respond quickly to provide the loan information you've asked for. As part of the review process, I will check your credit rating in order to find the best program for your loan.

Click here to print your application and send by Fax or regular mail.

This form is sent via a secure connection. If you don't see https in the address window, click here.

Borrower

 *First Name:
Middle Initial:
 *Last Name:
Suffix:
*Birth Date  (ddmmyyyy - all numbers)
 *Social Security # -10 numbers - 6171234567 - no dashes or ():
*Home (or Cell) Phone: 10 numbers only- 6171234567 - no dashes or ()
Work Phone:
Cell Phone:
*Street Address     *City  * State   *Zip
*Email:
Employer

Name:
Street:      
City:      State:         Zip:
Position    Years Employed   * Monthly Income (numbers only)

Previous Employer if employed less than 2 years,

Name:
Street:      
City:     State:         Zip:
Position    Years Employed      Monthly Income (numbers only)
Banks for Borrower
Bank 1   *Balance
Bank 2     Balance
Bank 3     Balance
 
Stocks
Retirement and/or 401K

CoBorrower

Complete this section only if there is a CoBorrower for this applicaton.

Coborrower entries marked with an asterisk (*) must be completed to process the application.

*First Name:
Middle Initial:
 *Last Name:
Suffix:
*Birth Date :  (ddmmyyyy - numbers only)
 *Social Security # :
*Home (or Cell) Phone: 10 numbers only- 6171234567 - no dashes or ()
Work Phone:
Cell Phone:
*Street Address     *City   *State   *Zip
*Email:
Employer

Name:
Street:      
City:      State:         Zip:
Position  Years Employed   Monthly Income (numbers only)

Previous Employer if employed less than 2 years,

Name:
Street:      
City:       State:         Zip:
Position   Years Employed    Monthly Income (numbers only)
Banks for CoBorrower
Bank 1  * Balance
Bank 2     Balance
Bank 3     Balance
Stocks
 Retirement and/or 401K

Loan Amount

*Amount Applying For:

$

Desired Type
of Loan:

30 Year Fixed
15 Year Fixed
Interest Only
Adjustable Rate
Other

Property

*Property Value or Purchase Price:

$

  

Type of Property:

Single Family
Multi-Family
Condo/Townhouse
Equity Loan
Commercial
Enter any questions or comments here: