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First Name:
Last Name:
Spouse's First Name:
Address:
City, State, Zip , CA
Home Phone:
Work Phone:
Best To Call:
E-mail:
Purpose of Loan:
Amount Requested:
Approx. value of your home:
1st mortgage balance:
Interest Rate: %      Fixed  Adjustable
Monthly Payment:
Including Taxes & Ins?:
Are you paying PMI ins?:
2nd Mortgage Balance:
Interest Rate: %      Fixed  Adjustable
Monthly Payment:
How long have you had this loan?:
How much are your car payments?:
How much in credit card debt?:
Total minimum monthly payments on credit cards?
(Mr.) Annual Income:
How long at job?:
Self Employed?:
(Mrs.) Annual Income?:
How long at job?
Self Employed?:
I will probably need an EZ Qualifier program:    Yes  No
Credit on a scale of 1 to 10?:
Check if applicable:  
 
Bankruptcy
  Foreclosure
  Judgements / Chargeoffs
  Leins
Social Security #'s (Optional)
Mr:
Mrs:

By submitting this on-line application, I/We authorize Lincoln Funding to check such things as my/our credit, business and employment status and histories.