Approval Request
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Benchmark Mortgage | 1750 E. Golf Rd., Suite 310 | Schaumburg. IL 60173
Illinois Residential Mortgage Licensee   
Primary Borrower
First Name:
Last Name:
Email:
Phone:
Address:
City:
State:
Zip Code:
Will There be a Co-Borrower?
Enter SAME if Applicable for Co Borrower
First Name:
Last Name:
Email:
Phone:
Address:
City:
State:
Zip Code:
Loan Information
Desired Loan Program
Purchase or Refinance
If a Purchase- Do You
Need a Recommendation
For a Realtor?
Property Use:
Property Value:
Desired Loan Amount:
Credit & Income
How Would You Rate
Your Credit?:
Gross Monthly Income:
Monthly Consumer Debt:
Comments:
All Fields Are Required