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Dick Scott
President
ONLINE LOAN APPLICATION
Loan Information
Loan Purpose:
Purchase
Construct Home
Refinance - No Cash
Refinance - Other
Refinance - Home Improvement
Refinance - Debt Consolidation
Refinance - Change Loan Type
Construction to Permenant
Other Loan Purpose
Property Type:
Select One
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Primary Residence
Secondary Residence
Investment Property
Loan Type:
30 Year Fixed
25 Year Fixed
20 Year Fixed
15 Year Fixed
10 Year Fixed
5 Year Balloon
7 Year Balloon
FHA 30 Year Fixed
VA 30 Year Fixed
Interest Rate:
Select One
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5.000
5.125
5.250
5.375
5.500
5.625
5.750
5.875
6.000
6.125
6.250
6.375
6.500
6.625
6.750
6.875
7.000
7.125
7.250
7.375
7.500
7.625
7.750
7.875
8.000
8.125
8.250
8.375
8.500
8.625
8.750
8.875
9.000
9.125
9.250
9.375
9.500
9.625
9.750
9.875
10.000
10.125
10.250
10.375
10.500
10.625
10.750
10.875
11.000
11.125
11.250
11.375
11.500
11.625
11.750
11.875
12.000
12.125
12.250
12.375
12.500
12.625
12.750
12.875
13.000
13.125
13.250
13.375
13.500
13.625
13.750
13.875
14.000
14.125
14.250
14.375
14.500
14.625
14.750
14.875
15.000
15.125
15.250
15.375
15.500
15.625
15.750
15.875
16.000
Loan Amount:
Market Value:
Down Payment:
Property Address:
City, State, Zip:
AL
AR
AK
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WI
WV
WY
Borrower Information
First Name:
Last Name:
Home Phone:
Marital Status:
Select One
----------
Married
Single
Separated
Age:
Email Address:
Co-Borrower Information
First Name:
Last Name:
Home Phone:
Marital Status:
Select One
----------
Married
Single
Separated
Age:
Email Address:
SCOTT MORTGAGE
200 Vestavia Parkway, Suite 2600
Birmingham, Alabama 35216
823-9011
