Form

Why Not Apply Now. It's Easy!

Email us! Just fill in the on-line application below and press submit. We
will receive your application by email.and respond promptly.
OR...
Fax us! Fill in the on-line application <no link> , print it and then fax it
to us. We can receive 24 hours a day...7 days a week.
OR...
Call us! We'll be happy to take your application over the phone or answer
any other questions you may have.

American Lenders Annex
877-503-5363
877-513-5363 fax

Property must be located in the following states:
 Alaska, California, Florida, Hawaii, Idaho, Oregon, Washington

This is a fully automated form and secured for your protection. We will respond to your inquiry within 24 hours.
*Red asterisk = Required Field.

Name

Email
Out of curiosity . . .
how did you hear about us?
Purpose of Loan*:
Mortgage Type:*
Amount Requested:*
Term:
Information About You and Co-Borrower
 Borrower Co-borrower
First Name*

Last Name*
Address
City, State
Zip, County
Email*
Home Phone (incl. area code)
Work Phone (incl. area code)
Best Time to call:
Social Security Number
How would you rate your credit?
Negative credit explanations:

Are you self employed?*
 Yes No Yes No
How long at present employment?
OK to call at work?*
Yes No Yes No
Gross Monthly Income:*
Other Income Source:
Amount of Other Income:

Information About Your Property
Property Type*
Property Usage:*
Purchase Price:*
Year Purchased:*
Current Value:*
Address of Property*:
City, State, Zip
* fill in only if different from residence

First Mortgage: Second Mortgage:
Existing Balance:
Monthly Payment:
Lender:
Existing Balance:
Monthly Payment:
Lender:
Do you own other property? Yes No

Questions, concerns, comments

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