Elite Home Mortgage

1517 N. Ankeny Blvd., Ste. A
Ankeny, IA 50023

P 515.965.1707
F 515.965.4500

personal information
Full name	Home phone
Address	Work phone
City	Fax
State Zip	Best time to call am pm
email	Best contact number
How did you hear about us?
loan information
Purpose of loan
Property value $
Loan amount you are applying for $ or % down payment $
Is there a co-borrower? yes no
Are you currently working with a realtor? yes no
Do you currently own any real estate? no yes, i own properties
How is your credit? excellent ok, but some problems major credit problems don't know
Estimated monthly debt Estimated monthly income
Do you currently own rent
Current house payment/rent (please include taxes and insurance)

network funding, lp.