Allstate Mortgage Loans & Investments

Allstate Mortgage Loans and Investments, Inc Ocala Florida

ONLINE MORTGAGE APPLICATION

Please complete this form to best of your ability. Only name and contact info is required. You will be contacted by an AllState Mortgage Representative.

If you prefer to give this information over the phone, or if you have any questions, please call us in Ocala: 352-351-0200 or toll-free 800-351-0200.

General Information

Loan Purpose:

Purchase
Refinance
Line of Credit
Construction
2nd Mortgage
Other

Type of Loan requested:

Loan Amount:

Term Requested (Number of years 5-30):

Primary Borrower completeLeft side/ Co-Borrower complete Right side

Contact/Borrower('s) Personal Information
Primary Borrower	Name (First, Middle, Last, Suffix)	Co-Borrower
	Complete E-mail Address *Required
	Rent Or Own?
	Current Residence Address
	City, State, Zip Code
	Time at Current Residence
	Home Telephone Number
	Work Telephone Number
	Social Security Number
	Date of Birth
	Marital Status

Employment/Income Information
	Self-Employed
	Name of Present Employer
	Address of Present Employer
	City, State, Zip Code
	Employer Phone
	Time on this job (Years/Months)
	Current Position or Title
	Gross Monthly Income

Other Income Only necessary if you want it to be considered for this loan
	Other Income Total
Social Security Pension Child Support Rental Other	Source Choose all that apply	Social Security Pension Child Support Rental Other

Liquid Assets
	Total Amount
Checking Savings 401K CD Investment/Other	Source Choose all that apply	Checking Savings 401K CD Investment/Other

Other Assets
	Auto (Year/Model/Value)
	Auto (Year/Model/Value)
	Boat / other Vehicle
	Real Estate Market Value (Tax asserted value)
	Other (Describe/Value)

Credit Rating
A B C D	Please Rate Your Credit	A B C D

Liability/Debt Information
	Total Liabilities (Current debt)
	Total Monthly Payment

How do you wish to be contacted?

Home Phone Work Phone E-mail Regular Mail

Best Time to Contact:

ONLINE MORTGAGE APPLICATION

Type of Loan requested: Select Fixed 1 year ARM 3/1 ARM 5/1 ARM 7/1 ARM 10/1 ARM Balloon Other Loan Amount: Term Requested (Number of years 5-30):

Contact/Borrower('s) Personal Information

Employment/Income Information

Liquid Assets

Credit Rating

Liability/Debt Information

Type of Loan requested:

Loan Amount:

Term Requested (Number of years 5-30):