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Concord Consultants
1038 Peninsula Blvd
Woodmere, NY 11598
Email: concordconsult
@optonline.net
Mortgage Application
  • Use this form to request mortgage information.
  • Please fill out as much of this form as possible. A loan officer will contact you, therefore a phone number is required.
  • When finished click the "Submit Form" button.
  • If you prefer to speak to a loan officer please call us at 1-800-797-0668
  • This form is absolutely secure using 3-WayEncryption™ built from SSL technology.
The information you enter on this form will be kept in strict confidence.
You can also apply using the short form.
Please do not use dollar signs($) or commas(,) when entering numbers.
Allen Margulefsky

Mortgage Type:
1st 2nd Home Equity
Amount Requested: $
Property Type Property will be:
Current Property To Be Refinanced
Address: Apt. or Unit# :
City: State: Zip:
IF REFINANCING FILL OUT THE FOLLOWING INFORMATION and then continue with Form
How long ago did you purchase yr. mo.
What was the purchase price? $
What do you think it is worth today? $
Do you own other property? YesNo If so, how many?
Existing Mortgages 1st Mortgage 2nd Mortgage
Mortgage Balance $ $
Monthly Mortgage Payment $ $
Please enter the monthly information for:
Taxes & Insurance
Are taxes and insurance included in your payment? Yes No
Personal Information
Applicant Co-Applicant
First Name
Last Name
Social Security Number
Date Of Birth
E-Mail
Home Phone
Work Phone
Cell Phone
Fax
How would you rate your credit?
Are you married to the Co-Applicant? YesNo  
Best time to contact you?
IF PURCHASE FILL OUT THE FOLLOWING INFORMATION
When do you expect to purchase? yr. mo.
When will home be completed? yr. mo.
What is the purchase price? $
What is your down payment? $
Do you own other property? YesNo If so, how many?
If purchase address is different than the property address
Did you? How Long? yr. mo.
Address: Apt. or Unit# :
City: State: Zip:
Current Address
(if less than 2 years at current) or If Purchase Actual Address.
Did you? How Long? yr. mo.
Address: Apt. or Unit# :
City: State: Zip:
Employment History
Applicant Co-Applicant
Employer Name
Gross Monthly Income* $ $
Your Position (title)
Self-Employed YesNo YesNo
Length with Company yrs. mos. yrs. mos.
Phone Number
Previous Employer (if less than 2 years at current)
Employer Name
Gross Monthly Income* $ $
Your Position (title)
Self-Employed YesNo YesNo
Length with Company yrs. mos. yrs. mos.
Comments

*Before Taxes & Deductions

By submitting this on-line application, I/we authorize your company to check such information as my/our credit, business and employment status and history. Submitting this application does not lock-in rate. Please call us at 800-797-0668 if you have any questions.
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For more information:
Concord Consultants Inc
1038 Peninsula Blvd
Woodmere, NY 11598 US
Email: concordconsult@optonline.net
1-800-797-0668

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