American Guaranty Mortgage and
Real Estate
Phone: 303-577-7245
Fax: 888-307-7673
Email: erikkrom@agmloan.com
 

Fields marked * are required
 Loan Purpose *
 Purchase Price (if applicable) 
 Desired Time for Closing 
 Property Type 
 Estimated Appraised Value 
 First Name *
 Last Name *
 SSN 
 DOB (mm/dd/YYYY) 
 Co Borrower First Name 
 Co Borrower Last Name 
 Co-Borrower SSN 
 Co-Borrower DOB (mm/dd/YYYY) 
 Address: Street (line 1) *
 Address: City *
 Address: State *
 Address: Zip *
 Subject Property (if different from current) 
 Property City 
 Property State 
 Property Zip 
 Email *
 Home Phone *
 Work Phone 
 Cell Phone *
 Are You Self Employed? 
 Borrower Employer 
 Borrower Yrs at Employer 
 Borrower Yrs in line of work 
 Borrower Total Monthly Income 
 Are You Self Employed? 
 Co-Borrower Employer 
 Co-Borrower Yrs at Employer 
 Co-Borrower Yrs in line of work 
 Co-Borrower Total Monthly Income 
 Assets Total (chcecking, savings, retirement, etc) 
 Present Rent (if applicable) 
 Current Loan Program 
 Current Loan Amount 
 1st mort payment 
 Current Loan Rate 
 Balance 2nd Mortgage (if applicable) 
 2nd mort payment 
 Rate 2nd Mort 
 Do you have a Pre-Payment Penalty? 
 Present Haz Ins 
 Present Taxes 
 Present HOA 
 Present MTG Ins 
 Occupancy 
 Intended Property Use 
 Refinance Purpose 
 Comments: 


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Real Estate