CMI - Preliminary App

If you are ready to begin the loan process,

you can submit your preliminary application using the form below.

For your protection, the information that you submit will be forwarded directly to a loan officer,

and WILL NOT be stored on our website. You will be contacted prior to processing.

If you are using Internet Explorer 7, and see a yellow bar like this:

you will need to allow the ActiveX option to complete this form.

This webpage uses Microsoft technology and WILL NOT harm your computer system.

If you prefer, a pdf version of this application is available for submission by fax.

Primary Borrower			Co-Borrower (if required)
Personal Information
Name: Last:			Name: Last:
First:			First:
Middle/Initial:			Middle/Initial:
Current Address:			Current Address:
Home telephone:			Home telephone:
Mobile telephone:			Mobile telephone:
Email address:			Email address:
Communication preference:			Communication preference:
Date of birth:			Date of birth:
Social Security number:			Social Security number:
Currently Rent or Own:			Rent or Own current residence:
Employment Information
Current Employer:			Current Employer:
Address:			Address:
Telephone:			Telephone:
Years at Employer:			Years at Employer:
Position:			Position:
Financial Information
Monthly Income:			Monthly Income:
Monthly Expenses:			Monthly Expenses:
Bank name	Account number	Current Balance	Bank name	Account number	Current Balance



Transaction Information
Property Type:			Property Address:
Loan type:			Loan Amount:
*** By clicking the submit button below, you acknowledge the following: ***
You hereby authorize Cook Mortgage to obtain credit information concerning you and your coborrower (if included on application). The authorization is given to Cook Mortgage to evaluate your request for credit. Verification may be obtained from any source named in the application and from any credit reporting agency. This application is for preliminary purposes only. A formal application will require a completed Uniform Loan Application Form 1003.