A Legion of Lenders
 
   
   

Please fill out the Application Form, and a representative will contact you shortly to begin your personalized Mortgage Solution.

  
     
Leejen Mortgage, Corp.
317.462.7777
888.861.4131
info@leejenmortgage.com
 
Applicant Name:
  
Date of Birth:
Co-Applicant Name:
Date of Birth:
Address of Property:
City:
State:
 Indiana
Zip:
Home Phone:
Work Phone:
 ext.
Best Time to Contact:
E-Mail:
Loan Type Desired:
Loan Amount Desired:
Property's Current Value:
Year Purchased:
Purchase Price:
Property Type:
1st Mortgage Balance:
1st Mortgage Interest Rate:
2nd Mortgage Balance:
2nd Mortgage Interest Rate:
Total Payments per Month:
Any late house or CC payments in last 3 years?
   Yes No
Gross Yearly Income:
  
Credit:
Are you a homeowner?
 Yes No
 

Please review all information carefully before submitting.

By clicking the button below, I/we do hereby authorize Leejen Mortgage, Corp. to verify any credit information contained in the above inquiry.