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Incomplete information may delay processing.

If you are unable to submit this form online, print it from your browser
and fax to 949-376-3155 or mail to:

Portfolio Financial Group
3100 Airway Ave.
Suite 112
Costa Mesa, CA 92626


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
Zip

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

EMPLOYMENT

Borrower's current employer
# years
$
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
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 949.276.8975      Fax 949.249.8973      E-mail info@portfoliofinancial.com
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