Mid-Cities Mortgage - Current Interest Rates

Fill out the application below to initiate the Loan Process.
After completion of application do one of the following :

Press the "Send Application" button at the bottom of the form to send as an unsecured message.
Print out this form and FAX it to us at (817) 285-0197.
Call us if you prefer at (817) 280-9696 and give us the information over the phone.

Application Information

Loan Amount:

Type of Loan:
Purchase Refinance Primary Residence
Second Home Income Property

If Refinancing Answer the following
What is your Current Rate?:
Current Monthly Payment (excluding taxes):
Annual Property Taxes:
Do you currently have Mortgage Insurance?: Yes No

Do you have a Second Mortgage or a line of credit on
the Subject Property?: Yes No

If yes, enter outstanding balance:
Do you want to keep this loan or consolidate it with the
first mortgage? Keep Consolidate

Customer Information

Name:
E-mail:
Current Street Address:
City: State: Zip Code:
Home Phone:
Work Phone: include extension if applicable

Property Information

Property Address:
Property City: Property State:
Property Zip Code:
Property Type:
Single Family Condo/Townhouse/Multiple Family Hotel/Condo
Will you occupy the property (either as vacation home or principal home)?:
Yes No

Credit Information

How would you rate your Credit?
Excellent Good Fair Poor

Employment Status
Salaried Self Employed

Employer:
Number of years with Company:
Gross Monthly Income:
Liquid Assets: (include checking, savings, stocks, mutual funds etc.)

Retirement and 401k:
Monthly Auto Payments
Credit Card Debt:

Thank you

Questions about this form? Phone 581-7383.

A Mid-Cities Mortgage Corp. loan representative will contact you shortly.