Provident Partners Companies Real Estate Services
 
Real Estate Investment
Property Management
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Please complete this page to begin the loan application process.
 Applying for your new mortgage is as easy as 1, 2 and 3...
use this secure server to apply online where all of your information is encrypted to help keep your data secure).

 
Call Us
Email us with your contact information and we will call you OR simply
call us at 480.314.1414 (toll-free 888.525.9093) to speak with a loan agent.
 
* Required  All information held in the strictest of confidence.
 

 Loan Purpose*

 

 When do you plan on buying a new home?
Within 30 days
 31-60 days
 61-90 days
 91-120 days or more
 
Do you have a real estate property selected?
Yes No
 
Are you currently working with a real estate agent?
Yes No
 
Have you worked with a Provident Partners Realtor or Mortgage Loan Officer?
 Yes No  If so please type name
 

 Employment History (2 years required)
Employment type
Employer name
Job title
Years at current employer
 years & months
Work phone
 

 Property Information
Property price or estimated value
Property use
Property type
 

 Loan Information
Loan amount

Please estimate how long you plan on keeping your home/loan.
 

 Income and Debt
Please provide combined information for all borrowers.

Gross income combined, all borrowers
 

Self Employment Income (if applicable): 

$ 2003 Profit from Schedule C (line 29)

$ 2003  Depreciation from Schedule C (line 13)

$ 2002 Profit from Schedule C (line 29)

$ 2002 Depreciation from Schedule C (line13)
Debt payments
- Include minimum payments only, not the entire balance.
  
 

 Assets
Account/Asset Type Bank / Institution Account Number Cash/ Asset Value
$
$
$
 
Auto Own/Lease Make/Model Year Value
$
$
 
 Schedule of Real Estate Owned
  Property Address (#1):
Check if this property is: your current residence, or: the subject property for this application.
Street: 
City, State, ZIP: 
Status: 
Property Type: 
Present Market Value:  $
Mortgage Liens: 
$
Mortgage Payments: 
$
Maint., Taxes, Ins.: 
$
Gross Rental Income: 
$
Net Rental Income: 
$
 
  Property Address (#2):
Check if this property is: your current residence, or: the subject property for this application.
Street: 
City, State, ZIP: 
Status: 
Property Type: 
Present Market Value: 
$
Mortgage Liens: 
$
Mortgage Payments: 
$
Maint., Taxes, Ins.: 
$
Gross Rental Income: 
$
Net Rental Income: 
$
 
  Property Address (#3):
Check if this property is: your current residence, or: the subject property for this application.
Street: 
City, State, ZIP: 
Status: 
Property Type: 
Present Market Value: 
$
Mortgage Liens: 
$
Mortgage Payments: 
$
Maint., Taxes, Ins.: 
$
Gross Rental Income: 
$
Net Rental Income: 
$
 If you own additional real estate please check here:
 

 Credit
In the past two years have you or your co-borrower:
Had any credit problems?
(Example 30-day-late payment)
 
Declared bankruptcy?
 
Had a foreclosure?
Your name*
 
Your email*
 
Phone number*
 
SS number* 
 
Birth Date* (mm/dd/yyyy)
 


The mortgage process involves communicating personal and financial data, and we understand the need for a safe and secure environment in which to share this information. We respect the trust you are giving us and we do not share, rent or sell any of your information to any person or organization. In addition to ensuring your confidentiality, we have several policies in place to protect the security of your data; including, secure web pages, encryption technology and firewall protection.

 
 

 

 MB # 0904112 (AZ)  
     

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