Residential Real Estate Financing valuation request form

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The following form is an abbreviated residential mortgage application. You may complete this mortgage application or qualify yourself based on the information provided. Submit the application to FLAGROUP.com and we will assist you with the process of obtaining a mortgage. Please complete the form in its entirity.

1) Client Contact Information
Name *:
Address *:
City *:
State or Province *:
Postal Code/ Zip *:
Country *:
Home Telephone *:
E-Mail Address *:
Location of Property:

2) Mortgage Information:
Purchase Price of Property:
Down Payment:
Down payment Percentage:
Mortgage Amount:
(Purchase Price less Down Payment)
Desired Mortgage Type:

3) Gross Monthly Income
Residential		Commercial		Industrial

Street Address:
City:
State and Zip:
Legal Description:
Sales Price or Estimate of Value:

3) Gross Monthly Income
Monthly Wages:
Monthly Bonus:
Other Monthly Wages:
Total Gross Monthly Income:

4) Monthly Payments or Non-Housing Debt:
Installment Loans:
Credit Card Payments:
Other Monthly Payments:
Total Gross Monthly Payments or Non-Housing debt:
Real Estate Taxes:
Home Owner's Insurance:

Additional Comments:

Please ensure the information given above is accurate, then use the Submit button.

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