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<!DOCTYPE HTML PUBLIC "-//SQ//DTD HTML 2.0 + all extensions//EN" "hmpro3.dtd">
<html>
<head>
<title>Banker of USA Mortgage: We Do All Real Estate Loans</title>
<meta name="keywords" content="loan, loans, home loan, mortgage, bank, loan broker, real estate loan, residential loan, low interest rate, refinance,West Los Angeles,California">
<meta name="description" content="Banker of USA Mortgate will guarantee all California Real Estate Loans to be the best price. We do Residental and commercail loans. Bad Credit OK.">
</head>
<body BGCOLOR="#FFFFFF" LINK="#FF0000" TEXT="#000000" ALINK="#FF0000" VLINK="#FF0000">
<p align="center"><img src="images/title.gif" alt="title.gif (18203 bytes)" WIDTH="700" HEIGHT="55"><br>
<br>
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<param name="text" value="Loan Rates">
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<param name="text" value="Loan Calculator">
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</p>
<div align="center"><center>
<table BORDER="0" VSPACE="0" WIDTH="600" HSPACE="0" CELLPADDING="0" CELLSPACING="0">
<tr>
<td WIDTH="500"><p align="center"><font color="#000080"><big><strong><big>Loan
Pre-Qualification Form</big></strong></big></font></p>
<p align="left"><a NAME="QUICKAPP">Instructions</a></p>
<ol>
<li>Please fill out as much information as possible. * is required field.</li>
<li>When finished click on the <font color="#FF0000">SUBMIT</font> button.</li>
</ol>
<form METHOD="POST" action="/scripts/polyform.dll/bankerusa">
<p>How did you find this Web site? <br>
<input TYPE="text" NAME="how_found_site" SIZE="60"> <br>
Borrower(s) Information </p>
<table BORDER="0" bgcolor="#FFFFD5" width="600">
<tr>
<td width="150">&nbsp;</td>
<td VALIGN="TOP"><font SIZE="+1"><b>Borrower</b></font></td>
<td><font SIZE="+1"><b>Co-borrower </b></font><br>
(If different)</td>
</tr>
<tr>
<td ALIGN="RIGHT" width="150"><font SIZE="-1">Full Name*:</font></td>
<td><input NAME="From" SIZE="22" MAXLENGTH="60"></td>
<td><input NAME="co-borrower_name" SIZE="22" MAXLENGTH="60"></td>
</tr>
<tr>
<td ALIGN="RIGHT" width="150"><font SIZE="-1">Address:</font></td>
<td><input NAME="Home-address" SIZE="22" MAXLENGTH="200"></td>
<td><input NAME="co_Home-address" SIZE="22" MAXLENGTH="200"></td>
</tr>
<tr>
<td ALIGN="RIGHT" width="150"><font SIZE="-1">City, State, Zip</font></td>
<td><input NAME="Customer-City" SIZE="11" MAXLENGTH="30"><input NAME="Customer-State" SIZE="2" MAXLENGTH="10"><input NAME="Customer-Zip" SIZE="5" MAXLENGTH="10"></td>
<td><input NAME="co_Customer-City" SIZE="11" MAXLENGTH="30"><input NAME="co_Customer-State" SIZE="2" MAXLENGTH="10"><input NAME="co_Customer-Zip" SIZE="5" MAXLENGTH="10"></td>
</tr>
<tr>
<td ALIGN="RIGHT" width="150"><font SIZE="-1">Home Phone*:</font></td>
<td><input NAME="home_phone" SIZE="22" MAXLENGTH="20"></td>
<td><input NAME="co_home_phone" SIZE="22" MAXLENGTH="20"></td>
</tr>
<tr>
<td ALIGN="RIGHT" width="150"><font SIZE="-1">Work Phone*:</font></td>
<td><input NAME="work_phone" SIZE="22" MAXLENGTH="20"></td>
<td><input NAME="co_work_phone" SIZE="22" MAXLENGTH="20"></td>
</tr>
<tr>
<td ALIGN="RIGHT" width="150"><font SIZE="-1">Best time to contact:</font></td>
<td><input NAME="best_time_to_contact" SIZE="22" MAXLENGTH="20"></td>
<td><input NAME="co_best_time_to_contact" SIZE="22" MAXLENGTH="20"></td>
</tr>
<tr>
<td ALIGN="RIGHT" width="150"><font SIZE="-1">E-mail*:</font></td>
<td><input NAME="~E-Mail" SIZE="22" MAXLENGTH="40"></td>
<td><input NAME="co_email_address" SIZE="22" MAXLENGTH="40"></td>
</tr>
<tr>
<td ALIGN="RIGHT" width="150"><font SIZE="-1">Are you self employed ?</font></td>
<td><input TYPE="RADIO" NAME="b_self_employed" VALUE="yes"> Yes <input TYPE="RADIO" NAME="b_self_employed" VALUE="no"> No</td>
<td><input TYPE="RADIO" NAME="c_self_employed" VALUE="yes"> Yes <input TYPE="RADIO" NAME="c_self_employed" VALUE="no"> No</td>
</tr>
<tr>
<td ALIGN="RIGHT" width="150"><font SIZE="-1">Length of Employment:</font></td>
<td><input NAME="b_years_on_job" SIZE="22" MAXLENGTH="20"></td>
<td><input NAME="c_years_on_job" SIZE="22" MAXLENGTH="20"></td>
</tr>
<tr>
<td ALIGN="RIGHT" width="150"><font SIZE="-1">Gross Monthly Income:</font></td>
<td><input NAME="b_gross_monthly_income" SIZE="22" MAXLENGTH="20"></td>
<td><input NAME="cob_gross_monthly_income" SIZE="22" MAXLENGTH="20"></td>
</tr>
<tr>
<td ALIGN="RIGHT" width="150"><font SIZE="-1">Date of Birth:</font></td>
<td><input NAME="b_age" SIZE="22" MAXLENGTH="20"></td>
<td><input NAME="c_age" SIZE="22" MAXLENGTH="20"></td>
</tr>
<tr>
<td VALIGN="TOP" ALIGN="RIGHT" width="150"><font SIZE="-1">My credit history is:</font></td>
<td VALIGN="TOP"><input TYPE="radio" NAME="credit_history" VALUE="excellent">excellent <br>
<input TYPE="radio" NAME="credit_history" VALUE="good but some lates">good <br>
<input TYPE="radio" NAME="credit_history" VALUE="some credit problems">some credit
problems <br>
<input TYPE="radio" NAME="credit_history" VALUE="major credit problems">major credit
problems <br>
<input TYPE="radio" NAME="credit_history" VALUE="major credit problems">don't know </td>
<td VALIGN="TOP"><input TYPE="radio" NAME="co_credit_history" VALUE="excellent">excellent <br>
<input TYPE="radio" NAME="co_credit_history" VALUE="good but some lates">good<br>
<input TYPE="radio" NAME="co_credit_history" VALUE="some credit problems">some credit
problems <br>
<input TYPE="radio" NAME="co_credit_history" VALUE="major credit problems">major credit
problems <br>
<input TYPE="radio" NAME="co_credit_history" VALUE="major credit problems">don't know </td>
</tr>
</table>
<h3>Loan Request</h3>
<table BORDER="0" bgcolor="#FFFFD5" width="600">
<tr>
<td ALIGN="RIGHT">Amount Requested:</td>
<td><input NAME="loan_amount_requested" SIZE="14" MAXLENGTH="20"></td>
</tr>
<tr>
<td ALIGN="RIGHT">Type of loan:</td>
<td><select NAME="loan_type" size="1">
<option VALUE="purchase" SELECTED="SELECTED">Purchase</option>
<option VALUE="refinance">Refinance</option>
<option VALUE="refinance_cash_out">Cash out refinance</option>
<option VALUE="credit_line">Credit line</option>
<option VALUE="equity_loan">Equity loan</option>
<option VALUE="construction">Construction</option>
<option VALUE="construction_permanent">Construction-Permanent</option>
<option VALUE="other">Other</option>
</select></td>
</tr>
</table>
<h3>Property Information<br>
<font SIZE="-1"><b>(This information needs to be filled out for property that is
collateral for the loan)</b></font></h3>
<table BORDER="0" bgcolor="#FFFFD5" width="600">
<tr>
<td ALIGN="RIGHT">Street Address:</td>
<td><input NAME="Home_address" SIZE="25" MAXLENGTH="200"></td>
</tr>
<tr>
<td ALIGN="RIGHT">City, State, Zip Code:</td>
<td><input NAME="Customer-City-St-Zip" SIZE="35" MAXLENGTH="200"></td>
</tr>
<tr>
<td ALIGN="RIGHT">Estimated Present Value:</td>
<td><input NAME="property_value" SIZE="10" MAXLENGTH="20"></td>
</tr>
<tr>
<td ALIGN="RIGHT">Year Purchased:</td>
<td><input NAME="year_purchased" SIZE="10" MAXLENGTH="20"></td>
</tr>
<tr>
<td ALIGN="RIGHT">Original Price:</td>
<td><input NAME="original_price" SIZE="10" MAXLENGTH="20"></td>
</tr>
<tr>
<td VALIGN="TOP" ALIGN="RIGHT">Type of Property:</td>
<td><input TYPE="RADIO" NAME="property_type" VALUE="primary" SIZE="10" MAXLENGTH="20">Primary
<input TYPE="RADIO" NAME="property_type" VALUE="second_or_vacation" SIZE="10" MAXLENGTH="20">Second/Vacation <input TYPE="RADIO" NAME="property_type" VALUE="investment" SIZE="10" MAXLENGTH="20">Investment </td>
</tr>
<tr>
<td ALIGN="RIGHT">Purchase Amount:</td>
<td><input NAME="purchase_amount" SIZE="10" MAXLENGTH="20"></td>
</tr>
</table>
<h3>Loan Information</h3>
<table BORDER="0" bgcolor="#FFFFD5" width="600">
<tr>
<td><b>Mortgage Balances</b></td>
<td>Amount:</td>
<td>Held by:</td>
<td>Payment:</td>
</tr>
<tr>
<td ALIGN="RIGHT">First:</td>
<td><input NAME="1st_mortgage_bal" SIZE="7" MAXLENGTH="20"></td>
<td><input NAME="1st_mortgage_holder" SIZE="14" MAXLENGTH="20"></td>
<td><input NAME="1st_mortgage_payment" SIZE="7" MAXLENGTH="20"></td>
</tr>
<tr>
<td ALIGN="RIGHT">Second:</td>
<td><input NAME="2nd_mortgage_bal" SIZE="7" MAXLENGTH="20"></td>
<td><input NAME="2nd_mortgage_holder" SIZE="14" MAXLENGTH="20"></td>
<td><input NAME="2nd_mortgage_payment" SIZE="7" MAXLENGTH="20"></td>
</tr>
<tr>
<td ALIGN="RIGHT">Other:</td>
<td><input NAME="other_mortgage_bal" SIZE="7" MAXLENGTH="20"></td>
<td><input NAME="other_mortgage_holder" SIZE="14" MAXLENGTH="20"></td>
<td><input NAME="other_mortgage_payment" SIZE="7" MAXLENGTH="20"></td>
</tr>
</table>
<table BORDER="0" bgcolor="#FFFFD5" width="600">
<tr>
<td><b>Creditors</b></td>
<td>Amount Owed</td>
<td>Monthly Payment</td>
<td><font SIZE="-1">Will you pay this off ?</font></td>
</tr>
<tr>
<td><input NAME="creditor1" SIZE="14" MAXLENGTH="20"></td>
<td>$<input NAME="amount_owed_1" SIZE="14" MAXLENGTH="20"></td>
<td>$<input NAME="monthly_payment_1" SIZE="14" MAXLENGTH="20"></td>
<td ALIGN="RIGHT"><input TYPE="RADIO" NAME="payoff_1" VALUE="yes" SIZE="7" MAXLENGTH="20">
Yes <input TYPE="RADIO" NAME="payoff_1" VALUE="no" SIZE="14" MAXLENGTH="20"> No</td>
</tr>
<tr>
<td><input NAME="creditor2" SIZE="14" MAXLENGTH="20"></td>
<td>$<input NAME="amount_owed_2" SIZE="14" MAXLENGTH="20"></td>
<td>$<input NAME="monthly_payment_2" SIZE="14" MAXLENGTH="20"></td>
<td ALIGN="RIGHT"><input TYPE="RADIO" NAME="payoff_2" VALUE="yes" SIZE="7" MAXLENGTH="20">
Yes <input TYPE="RADIO" NAME="payoff_2" VALUE="no" SIZE="14" MAXLENGTH="20"> No</td>
</tr>
<tr>
<td><input NAME="creditor3" SIZE="14" MAXLENGTH="20"></td>
<td>$<input NAME="amount_owed_3" SIZE="14" MAXLENGTH="20"></td>
<td>$<input NAME="monthly_payment_3" SIZE="14" MAXLENGTH="20"></td>
<td ALIGN="RIGHT"><input TYPE="RADIO" NAME="payoff_3" VALUE="yes" SIZE="7" MAXLENGTH="20">
Yes <input TYPE="RADIO" NAME="payoff_3" VALUE="no" SIZE="14" MAXLENGTH="20"> No</td>
</tr>
<tr>
<td><input NAME="creditor4" SIZE="14" MAXLENGTH="20"></td>
<td>$<input NAME="amount_owed_4" SIZE="14" MAXLENGTH="20"></td>
<td>$<input NAME="monthly_payment_4" SIZE="14" MAXLENGTH="20"></td>
<td ALIGN="RIGHT"><input TYPE="RADIO" NAME="payoff_4" VALUE="yes" SIZE="7" MAXLENGTH="20">
Yes <input TYPE="RADIO" NAME="payoff_4" VALUE="no" SIZE="14" MAXLENGTH="20"> No</td>
</tr>
</table>
<p>Other monthly debts and information - please describe</p>
<p><textarea NAME="other_info" ROWS="5" COLS="55" WRAP="HARD"></textarea> </p>
<div align="center"><center><p><input TYPE="submit" VALUE="Submit"><input TYPE="reset" VALUE="Reset"> </p>
</center></div><p><font SIZE="-1"><strong>Notice</strong>: By submitting this on-line
application, I/We authorize Banker of USA Mortgage to check such things as my/our credit,
business and employment status and histories.</font></p>
</form>
</td>
</tr>
</table>
</center></div>
<p align="center"><strong><font color="#000000"><br>
</font><font color="#000000"><small><a href="indexbak.html">HOME</a> | <a href="loan.htm">LOAN
RATES</a> | <a href="apply.htm">APPLY ONLINE</a> | <a href="loancalc.htm">LOAN CALCULATOR</a></small></font></strong></p>
</body>
</html>