Please complete the following information to the best of your ability. If you cannot complete one of the questions for whatever reason please move on to the questions you can answer, we will contact you if additional information is required. You may submit this application electronically or you may print it out and submit it by fax to 316-219-2155. You may also submit this application over the phone by calling 316-945-2155. Or simply email us with your phone number and we'll call you. Please don't hesitate to contact us with any questions you may have. Thank you for choosing Kansas Mortgage Center. Loan Information Type of loan Purchase Refinance Occupancy Primary Residence Second Home Investment Property (Not owner-occupied) Loan Amount $ Loan Term 10 Year 15 Year 20 Year 30 Year40 Year Rate Your Credit A B C D Borrower Information BORROWER CO BORROWER Contact Information E-Mail Address First Name, MI, Last Name Home Telephone Number Cellular Telephone Number Address Street Address City, State, Zip Own or Rent Own Rent Property Information Are you a first time home buyer? Yes No Have you located a property? Yes No Purchase Price $
Please complete the following information to the best of your ability. If you cannot complete one of the questions for whatever reason please move on to the questions you can answer, we will contact you if additional information is required.
You may submit this application electronically or you may print it out and submit it by fax to 316-219-2155. You may also submit this application over the phone by calling 316-945-2155. Or simply email us with your phone number and we'll call you. Please don't hesitate to contact us with any questions you may have. Thank you for choosing Kansas Mortgage Center.
Loan Information
Type of loan Purchase Refinance
Occupancy Primary Residence Second Home Investment Property (Not owner-occupied)
Loan Amount $
Loan Term 10 Year 15 Year 20 Year 30 Year40 Year
Rate Your Credit A B C D
Borrower Information
Property Information
Are you a first time home buyer? Yes No
Have you located a property? Yes No
Purchase Price $
Please click on "Submit this Application" below if you agree to the following:
I certify that the information I have provided is true and correct. I authorize Kansas Mortgage Center, to verify any information included in this application or in other documents required to obtain the loan I am requesting. I also authorize any party named in this application to provide any and all information Kansas Mortgage Center. may request, such as employment history, credit history, income and income tax returns, and bank, money market, and similar account balances.
I understand that Kansas Mortgage Center will incur time and expense on my behalf to process and approve my loan. Therefore, I agree that if Kansas Mortgage Center approves my loan and closing of the loan can not occur due to any act, failure to act, or misrepresentation on my part, I will pay Kansas Mortgage Center one percent (1%) of the loan amount as well as any fees which Kansas Mortgage Center has paid to third parties on my behalf.
I understand that I may submit my application to Kansas Mortgage Center electronically by clicking "Submit This Application" below, or I may submit the application by fax or mail. If I choose to submit this application electronically, I acknowledge that, regardless of the fact that Netscape Navigator security features are available, Kansas Mortgage Center is unable to ensure that the data can not be intercepted by third parties. I agree that Kansas Mortgage Center will not be held liable should such interception occur. This is not an offer to lock and does not meet truth-in-lending requirements. Rates are subject to change and depend on loan amount, appraised value, and length of lock. Truth-in-lending documents and good faith estimates will be furnished at application or upon request.
