Information About Yourself 
Is This Loan for the Purchase of a Property or a Refinance? 

Expected Years in House, Cannot Exceed Term 

What Do You Expect Your Down Payment to Be? 

Income Tax Bracket ( e.g. 27 ) 

Loan Amount (e.g. 100000) 

Will Mortgage Insurance be Deductible for You? 
Yes
No

Basic Loan Information 

FRM 
ARM 
Initial Interest Rate on Loan (e.g. 7.50) 


Points (% of Loan) 


Loan Term (in years) 


Other Upfront Fees and Charges —(May be Entered as a % of Loan or $$ Amount) 
Type of Fee 
FRM 
ARM 
Application Fee (Usually a $$ Amount) 


Commitment Fee (% of Loan) 


Origination Fee (Usually % of Loan) 


Mortgage Broker Fee (Usually % of Loan) 


Credit Report ($$ Amount) 


Appraisal ($$ Amount) 


All Other Fees Paid to Lender 


Mortgage Insurance (Monthly Premium in dollars) 


Payment Information — (ARM Only) 
Initial Monthly Payment of Principal and Interest (e.g., 753.45) 

Payment Adjustment Period, in Months (e.g., 12) 

Payment Adjustment Cap, in Percent (e.g., 7.5  if no cap, leave blank) 

Payment Recast Period, in Years (e.g., 5  if no recast period, leave blank) 

Negative Amortization Cap, in Percent (e.g., 110  if no cap, leave blank) 

Interest Rate Information — (ARM Only) 
Current Value of ARM Interest Rate Index ( e.g. 1.54 ) 

Margin That is Added to Interest Rate Index (e.g. 2.75) 

Number of Months to First Rate Adjustment (e.g. 36) 

Duration, in Months, Between Subsequent Rate Adjustments (e.g. 12) 

Maximum Interest Rate Over Life of Mortgage (e.g. 12.5) 

Minimum Interest Rate Over Life of Mortgage (e.g. 4.5) 

Assumptions About Future Interest Rates — (ARM Only) 
Stable Index: — Interest Rate Index Stays Unchanged for Life of Mortgage 
Worst Case: — Interest Rate Rises to the Maximum Allowable Rate in the Second Month 

Number of Years 
Percent Per Year 
Upward Movement: — Interest Rate Index Rises for: 


Downward Movement: — Interest Rate Index Declines for: 



Years Between Direction Changes 
Percent Per Year 
Volatile: — Interest Rate Index Rises, Then Declines: 


Volatile: — Interest Rate Index Declines, Then Rises: 

