Home and Construction Loans. Mortgage Brokers of Oregon and Washington

Please, fill out all fields carefully. Remember,
we'll use 'Your Personal Information' to contact you.

Fields marked (*) are required

Click here to learn more about GetRate service
Your Personal Information
Your full name (*)
Contact phone # (*)
Your E-mail (*)
Best time to call
Subject Property Information and Purpose of Loan
street
city
state
zip
No. of Units (*)
Year Built
Market Value (*)
Loan Amount
Purpose of loan (*)
Property will be (*)
Fill 4 lines below if it is REFINANCE loan
Your Present Rate(*)
Year Acquired (*)
Original Cost (*)
Amount Existing Liens (*)
Purpose of Refinance
Source of Down Payment and other payments
Monthly Income and Combined Housing Expense Info
Base Empl. Income
Rent
First Mortgage (P&l)
Other Financing (P&l)
Hazard Insurance
Real Estate Taxes
Mortgage Insurance
Assets and Liabilities (List all outstanding debs, including auto loans, revolving charge accounts, real estate loans, alimony child support, stock piedges, ets.)
(1) Name and address of Company
(1) Monthly payment
(1) Unpaid balance
(2) Name and address of Company
(2) Monthly payment
(2) Unpaid balance
(3) Name and address of Company
(3) Monthly payment
(3) Unpaid balance

If you have any questions, comments or offers feel free to call us at (503) 977-0810 or send us e-mail to info@efshomeloans.com

This form is 100% secure. We are using 128 bit encryption to secure all your information.

All information recieved from our clients is subject to a Privacy Policy.

Executive Financial Solutions, Inc.
7000 SW Hamptom St., Ste 121
Portland, OR 97223
ph: (503)977-0810 fax: (503)977-0922