NOTE: To successfully submit your scenario to Empire Mortgage, please make sure that you enter data into every field of this form, as well as make the necessary selections (such as Property Type). Failure to do so will result in your scenario not being submitted to Empire. This information is intended to assist mortgage brokers only and is not intended for public use.
Broker Name:
Company Name:
Office Number:
Mobile Number:
Fax Number:
Email:
Last Name of Borrower:
FICO Scores:
Zoning:
Residential Land Commercial
Type:
Single-Family Residence Townhouse Mixed-Use Multi-Family Condo Other
Occupancy or Intended Usage:
City:
State:
Zipcode:
Date they acquired the Property:
Original Purchase Price of Property:
Current Property Value:
Has borrower ever been in foreclosure or filed bankruptcy in the past three years?:
Yes No
Existing Mortgage (Payoff Amount):
Pay History Status:
PLEASE NOTE THAT WE MUST KNOW THE 12 MONTH PAY HISTORY TO ISSUE PRE-APPROVAL
Current with clean 12-month pay history (No late payments) Current with ONLY X30's & No BK or Foreclosures in Last 3 Years Current with ONLY X60's & No BK or Foreclosures in Last 3 Years 60-Days Delinquent Now, No X90's & No BK or Foreclosures in Last 3 Years Or in Bankruptcy or Foreclosure 90-Days Delinquent or more
New Loan Balance:
Proposed Loan-To-Value:
Amount of Cash-Out:
List Debts Borrower wants to pay off:
Lien Position:
Loan Type:
Rate & Term Refinance Cash-Out Refinance Bail-out (FCL or BK) Debt Consolidation Other:
Additional Notes:
Only completed scenario forms will be reviewed.
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