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LOAN REQUEST APPLICATION *For security purposes, a MCR Financial representative will contact you for your social security number.

LOAN INFORMATION
Loan Amount:
*Loan Position:	1st 2nd
Loan Purpose:	Select One > Purchase Cash-Out Refi Construction Other
*Down Payment :
PROPERTY INFORMATION
*Approximate Value:
Sales Price:
Property Type:	Select One > Residential Commercial Mixed-Use Church Other
*Occupancy:	Select One > Primary Secondary Investment
*Address:
*City:
*State:
*Zip Code:
*County:
BORROWER INFORMATION
*First Name:
*Last Name:
*Address:
*City:
*State:
*Zip Code:
*Home Phone #:
Bus Phone #:
Email:
*Total Income:
*Total Housing Expenses:
REFERRED BY
First Name:
Last Name:
Title:
Company:
Phone #:
Email:
Comments: