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please print it from your browser and fax to 949-715-7892 or mail to:

Portfolio Financial Group
931 S. Coast Hwy.
Laguna Beach, CA 92651


Date
E-mail
$
Loan Amount Requested		 $
Estimated value of property

APPLICANT(S)

Borrower's name
Age
Social Security #
(Please enter numbers
only without hyphens.)

Co-Borrower's name
Age
Social Security #
(Please enter numbers
only without hyphens.)

Address
City, State and Zip

Number of years at this address
Area code & phone number
(Please enter numbers
only without hyphens.)

EMPLOYMENT

Borrower's current employer
Number of years with current employer
$
Gross monthly income
Employer's phone
(Please enter numbers
only without hyphens.)

If self-employed, check here and state nature of work.


Position

Co-Borrower's current employer
# years
$
Gross monthly income
Employer's phone
(Please enter numbers
only without hyphens.)

If Co-Borrower is self-employed, check here and state nature of work.


Co-Borrower position

REAL ESTATE
Loan Purpose:
Purchase
Refinance
Other

Property Address
City, State and Zip

First mortgage holder
Monthly payment
Balance

Second mortgage holder
Monthly payment
Balance

 

Special requests, notes or issues of concern



Signature of Borrower
(Please type if submitting online.)



Signature of Co-Borrower
(Please type if submitting online.)



Loan processing office



Best contact number and time to call
(Please enter numbers only without hyphens.)
 

By clicking the Submit button below,
I authorize Portfolio Financial to obtain credit information on my behalf
for the sole purpose of delivering a loan proposal as requested.

       

 
Phone 949.715.7769     Fax 949.715.7892      E-mail info@portfoliofinancial.com
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