Mortgage Fitness Check-Up

Name:	(required)
Email:
Phone:	(required)
Best time to call:

1. Current estimated market value of home? $

2. Original amount of current 1st mortgage?

3. Start date of current mortgage? (mm/dd/yyyy)

4. Current interest rate? %

5. Balance of current 1st mortgage? $

6. Type of Mortgage (check appropriate boxes):
   Fixed Rate: 30 yr 20 yr 15 yr 10 yr Other:
   Adjustable Rate: 1 yr 3 yr 5 yr 7 yr 10 yr
   Balloon: 5 yr 7 yr Other:
   Interest Only: Yes No

7. Annual Property Taxes? $

8. Annual Homeowners Insurance? $

9. 2nd Mortgage Information (if applicable):
   Type: Line of Credit Closed End Installment
   Balance of 2nd mortgage? $
   Interest Rate? %
   Payment Amount? $
   If line of credit, what is the high credit amount? $
   If closed end installment loan, what was the original loan amount? $

10. Liabilities:
    Revolving balances? $ (credit cards, line of credit, etc.)
    Revolving payments? $
    Installment balances? $ (student loans, car loans, etc.)
    Installment payments? $
    Other balances? $
    Other payments? $

11. Are you able to deduct mortgage interest expense on tax returns?
    Yes
    No
    Not Sure

12. How long do you plan to live in your current home?
    

13. Realistically, how much do you expect your household income to increase or decrease in the next:
    2 years?
    5 years?

14. Do you foresee incurring other financial obligations within the next 5 years, such as:
    A new car? Yes No
    Change in work time? (Switch to part time) Yes No
    A new baby? Yes No
    College Expense? Yes No
    Other:

15. Which of the following personal goals are most important to you? Please rank in order of importance to you with 1 being the most important and 7 being the least important.
    Building your net worth
    Moving to a larger home within ____ years
    Having your mortgage paid off when you retire in _____ years
    Achieving financial freedom
    Saving money to send kids to college
    Investing in the stock market
    Other

16. Do you currently have a written (formal) household budget? Yes No

17. What mortgage payment do you feel comfortable making?

18. How would you best describe your financial philosophy?
    Conservative
    Moderate risk taker
    Risk taker

19. What is most important about this mortgage to you? Please rank in order of importance to you with 1 being the most important and 8 being the least important.
    Lowest payment
    Maximize tax benefits
    Lowest closing costs
    Paying the loan ASAP
    Improve credit history
    Lowest down payment
    Eliminating other debt
    Other

20. Do you work with a financial planner? Yes No
    How do you rate him/her? Excellent Good Average

21. Do you work with a stockbroker? Yes No
    How do you rate him/her? Excellent Good Average

22. Do you work with a life insurance agent? Yes No
    How do you rate him/her? Excellent Good Average

23. Do you have a tax deferred retirement plan at work? Yes No
    Do you participate in that plan? Yes No
    If yes, do you maximize your contribution? ($15,000.00 for 2006) Yes No

24. To protect your family’s assets in the event of something happening you, have you put in place:
    A will? Yes No
    A living trust? Yes No

    If so, how would you rate your attorney?
    Excellent Good Average

25. What is most important to you about working with a lender?

Thank you for taking the time to answer these questions. I look forward to meeting with you and helping you choose the best mortgage financing options for you own personal situation!