LOAN APPLICATION Loan Officer (Please Choose An Agent)KJ HardenDavid PriceDerek EisengaJim Luscinski(Req'd) Date Email Address(Req'd) Loan Amount Requested Estimated Value of Property or Requested Purchase Price Applicant(s) Borrower(Req'd) Age SSN (Req'd) --   Birthdate  (mm/dd/yyyy) Co-Borrower Age SSN? -- Address Years Phone () City State Zip Employment Borrower Present Employer Gross Monthly Income Position Years Phone () Co-Borrower Present Employer Gross Monthly Income Position Years Phone () Other Income Borrower Income/Source Monthly Amount Co-Borrower Income/Source Monthly Amount Real Estate Loan Purpose: Purchase Refinance Refinance with cash out Other Property Address City State Zip 1st Mortgage Holder Monthly Payment Months Left 2nd Mortgage Holder Monthly Payment Months Left Assets Bank or Savings & Loan Approx. Balance Bank or Savings & Loan Approx. Balance Bank or Savings & Loan Approx. Balance Bank or Savings & Loan Approx. Balance Comments The above information is correct to the best of my knowledge and I intend it to be relied upon for the purpose of the above application. By clicking on the Submit Application button below, I hereby authorize TriStar Home Mortgage LLC to make whatever inquiries it considers necessary and appropriate concerning such information. By clicking on the Submit Application button below, I hereby authorize my credit references to provide information to TriStar Home Mortgage LLC.

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