Five Star Mortgage Corp - All Loans Arranged Through 3rd Party Providers. Five Star Mortgage Corporation is not responsible for applications submitted in states other than those Five Star Mortgage Corporation is licensed in.

You will be contacted within 24 hours of application and there is no obligation throughout the loan application process!

ALL FIELDS MARKED WITH AN ASTERISK (*) MUST BE COMPLETED.

Applicant Information

First Name	*
Last Name	*
Marital Status	Married Single Unmarried
Will anyone else be applying with you?	Yes No
If yes, please enter their name.	First Last
And their relationship to you.	Relationship
How much do you want to borrow?

Are you currently a home owner? *	Yes No
Are you looking to purchase a home? *	Yes No

Property Information

CURRENT ADDRESS	Street
	City
	State	Zip Code
	What is the purchase price/value of the property?
REFINANCE ONLY
1st Mortgage Information	Lender
	Amount Owed
	Rate	Payment
	Years Remaining
2nd Mortgage Information	Lender
	Amount Owed
	Rate	Payment
	Years Remaining
PURCHASE ONLY
If you know the address of the house you're buying:	Street
	City
	State	Zip Code
	When would you like to close?

Employment Information

Employer	Applicant:	Self-employed Salaried Employee Other
	Co-Applicant:	Self-employed Salaried Employee Other
Income	Applicant:
	Co-Applicant:
Length of time in current job or field:	Applicant:	years
	Co-Applicant:	years
Other monthly income: (i.e.: rental, disability, etc.)	Applicant:

Additional Information

Social Security Number	Applicant:
	Co-Applicant:
	Purpose of loan

Contact Information

Telephone Numbers	Home	Work
	When's the best time to call?	E-mail:*
		E-mail Address (ex: john@fsmcorp.com)
	How did you find our site?

* I/We hereby give our consent to Five Star Mortgage Corp., and any credit reporting bureau designated to obtain any and all information concerning our employment, checking and/or savings account, obligations and all other credit matters which they may require in connection with our application for a mortgage loan. This form may be reproduced or photocopied and a copy shall be as effective consent as the original which we have submitted.

Five Star Mortgage Corporation
1376 Locust Avenue
Bohemia, NY 11716
Tel: 631.589.STAR (7827) Fax: 631.589.7011

Brought to you by Five Star Mortgage Corporation. No representation is made or is to be implied as to the accuracy thereof and all information submitted is subject to errors, omissions, rate change, acceptance conditions, or withdrawal without notice. ARM APRs may increase after consummation. Offer subject to credit approval. Advertised rates are prevailing and are subject to change without notice, and are for new applicants only. Five Star Mortgage Corporation cannot guarantee acceptance into any loan program, specific loan terms or conditions. Five Star Mortgage Corporation 1376 Locust Avenue, Bohemia, NY 11716 Registered Mortgage Broker -- NYS Banking Department Lic#A013838. All Loans Arranged Through 3rd Party Providers. Five Star Mortgage Corporation is not responsible for applications submitted in states other than those Five Star Mortgage Corporation is licensed in.