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90 Sec App
Primary Applicant Info

* Required

1.	I will be applying: Individually With a Co-Applicant (If with co-applicant, please fill in appropriate coapplicant information below)

2.	* First Name:	MI:	* Last Name:	Suffix:	Additional Surname:
2.

3.	Co-Applicant First Name:	MI:	Last Name:	Suffix:	Additional Surname:
3.

4.	* Date of Birth: (mm) / (dd) / (yyyy) Co-Applicant Date of Birth: (mm) / (dd) / (yyyy)

5.	* Contact numbers where you can be reached: *Contact Type:* Home Phone Cell Work Best Time to Call: *Contact Type:* Home Phone Cell Work Best Time to Call:

6.	* Email Address: I would like to receive information about DML special offers and promotions at this email address. I do not want to receive information about DML special offers and promotions at this email address.

7.	* Current Address:
	Street:
	City:
	State:
	Zip:
	How long have you been at your current address?: Years Months

8.	* Estimated Home Value:
	First Mortgage Balance: Rate:
	Second Mortgage Balance: Rate:
	Credit Card or Other Balances:

9.	* Are you currently employed?
	Selection option that best applies: Social Security Number: Co-Applicant Social Security Number:

10.	How did you hear about Directmortgageloans.com?
	Selection option that best applies:

Applicant or Co-Applicant information should be completed as applicable. Co-Applicant information must also be provided when the income or the assets of a person other than the "Applicant" (including the Applicant's spouse) will be used as a basis for loan qualification or the income or assets of the Applicant's spouse will not be used as a basis for loan qualification, but his or her liabilities must be considered because the Applicant resides in a community property state, the security property is located in a community property state, or the Applicant is relying on other property located in a community property state as a basis for repayment of this loan.

Married persons may apply for credit as an individual. If this is an application for an individual account and you are relying on your own income or assets (except community property states, your separate income or assets) and not the income or assets of another person (or community property) for repayment of the credit requested, questions relative to marital status and to income resources and assets of the spouse's need not be answered. However, only the applicant's resources will be evaluated in determining credit worthiness.

By submitting this application, you authorize Lenders to make whatever credit inquiries that it deems necessary in connection with this credit application or in the course of review, collection, refinancing or consolidation of any credit extended in reliance on this application. You authorize and instruct any person or consumer reporting agency to compile and furnish to Lenders any information that it may have to obtain in response to such information along with this application, shall remain Lenders's property whether or not credit is extended.

Lenders (or whichever of its affiliates may be considering an extension of credit pursuant to your credit application) may share with its affiliates any information it obtains from your credit application or acceptance certificate and any transactions and experiences between you and it. In addition, it may share with its affiliates any other information relation to you, however, you may request that such information not be shared with affiliates by notifying us in writing at any Lenders Branch.