Short Loan Application

How did you hear about us?

Are you a First Time Home Buyer? Yes No

Are you a Veteran? Yes No

Borrower Information

First Name

Last Name

Mailing Address

City

State

ZipCode

Phone

Best Time to Call

Total Gross Yearly Income (Income Before Taxes)

Notice: Alimony, child support, or separate maintenance income need not be revealed if the Borrower(B) or Co- Borrower(C) does not choose to have it considered for repaying this loan.

Total Monthly Debt Payments (including Alimony & Child Support)

Current Employer

Number of Years

Estimated Credit Score

Additional Borrower Information

Will there be a additional borrower on this loan? No additional borrower Spouse Other

Additional First Name

Additional Last Name

Additional Mailing Address

Additional City

Additional State

Additional ZipCode

Additional Phone

Best Time to Call

Additional Email

Additional Total Gross Yearly Income (Income Before Taxes)

Notice: Alimony, child support, or separate maintenance income need not be revealed if the Borrower(B) or Co- Borrower(C) does not choose to have it considered for repaying this loan.

Additional Total Monthly Debt Payments (including Alimony & Child Support)

Additional Current Employer

Additional Number of Years

Additional Estimated Credit Score

Loan Information

Loan Purpose

Property Type

Property Value / Sales Price

Desired Loan Amount

Additional Information

Priority Mortgage Lending, Inc. offers expertise and personalized service for new home purchases and refinancing to every kind of borrower in Acadiana.