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Short Application
Our short application is an easy and fast way to request a mortgage. Please provide the following information.
Personal Information
First Name:
Last Name:
Email:
Referral Name:
Home Phone:
( ) -
Cell Phone:
( ) -
Work Phone:
( ) - Ext.
Marital Status:
Are you a U.S. citizen?
Date of Birth:
 (mm/dd/yyyy)
Social Security or Tax ID #:
- -
Number of Dependents:
Dependent Age(s):
Separate ages by commas.
Loan Officer:
 
Current Address
Street Address:
City:
State:
Zip:
-
Years at this Address:
 Years     Months
Rent or Own:
 
Subject Property
Purpose of Loan:
Please Specify  
Property Usage:
Loan Amount:
$
Purchase Price:
$  
Number of Units:
 
Year Built:
Subject Property Address:
 
City:
State:
We only accept applications for the states listed.
Zip:
-
 
Monthly Income
Submitting income from alimony, child support, or separate maintenance income is optional if you do not want to use that income for qualification purposes.
Base Income:
$
Bonuses:
$
Commission:
$
Other Income:
$
 
Assets
Checking:
$
Savings:
$
Retirement Funds:
$
Mutual Funds:
$
Other:
$
 
Demographic Information
The purpose of collecting this information is to help ensure that all applicants are treated fairly and that the housing needs of communities and neighborhoods are being fulfilled. For residential mortgage lending, Federal law requires that we ask applicants for their demographic information (ethnicity, sex, and race) in order to monitor our compliance with equal credit opportunity, fair housing, and home mortgage disclosure laws. You are not required to provide this information, but are encouraged to do so. You may select one or more designations for "ethnicity" and one or more designations for "Race." The law provides that we may not discriminate on the basis of this information, or on whether you choose to provide it. However, if you choose not to provide the information and you have made this application in person, Federal regulations require us to note your ethnicity, sex, and race on the basis of visual observation or surname.The law also provides that we may not discriminate on the basis of age or marital status information you provide in this application. If you do not wish to provide some or all of this information, please check below.
   
Ethnicity - Check one or more:




For example: Argentinean, Colombian, Dominican, Nicaraguan, Salvadoran, Spaniard, and so on.

   
Race - Check one or more:
Enter name of enrolled or principal tribe:








For example: Hmong, Laotian, Thai, Pakistani, Cambodian, and so on.






For example: Fijian, Tongan, and so on.

   
Sex:


* Privacy Policy:
Internet Privacy Policy
Co-Borrower
Do you have a co-borrower?  
* = Required

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American Pacific Mortgage Corporation NMLS #1850/857413 NMLS #53711
1088 NE Orenco Station Parkway, Hillsboro, OR  97124
Office:  (503) 356-2241
Kimberly.Barry@apmortgage.com
Copyright © 2018 American Pacific Mortgage Corporation. All information contained herein is for informational purposes only and, while every effort has been made to ensure accuracy, no guarantee is expressed or implied. Any programs shown do not demonstrate all options or pricing structures. Rates, terms, programs and underwriting policies subject to change without notice. This is not an offer to extend credit or a commitment to lend. All loans subject to underwriting approval. Some products may not be available in all states and restrictions apply. Equal Housing Opportunity.

Licensed in AZ, OR, WA
AZ Corp BK 0906702

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