Fill out this short loan application and e-mail it directly to Servcice Mortgage (click the SUBMIT button).

We will contact you to set up an appointment.
To complete this order form, click "Send this mail to Service Mortgage" in the red bar at the bottom of the page.
Your Name (required)
Your Home Phone (required)
E-Mail Address (e.g. Tom@good.com)
(required; if you have no e-mail address, please enter "none")
Purchase Refinance Debt Consolidation    Other
Loan Amount: $   FMV: $   Amt. Owed $
Cash Out( Yes    No) Original Cost: $
Current Mtg holder:    Current Rate:
2nd Mortgage   Mobile Home   Other
Borrower Co-Borrower
  Name
  DOB/Age
  Soc. Sec. #  
  Employer
  Years employed
(if less than 2 years)
  Previous Employer
  Work Phone
  Monthly Income
Rent Own Other  
  Name
  DOB/Age
  Soc. Sec. #  
  Employer
  Years employed
(if less than 2 years)
  Previous Employer
  Work Phone
  Monthly Income
Rent Own Other  
Current Address:
Street/Apt#      City
State      Zip


(This is required.) I authorize you to provide to Service Mortgage and any investor to whom Service Mortgage may sell mortgage, any and all information and documentation that they request. Such information includes but is not limited to employment history and income, bank, money market and similar account balances, credit history and copies of income tax returns.

Uniform Residential Loan Applications may be downloaded from this page and printed for return to Service Mortgage. CLICK HERE

Located in the same building as Sternfels Insurance Agency, Plattenville, La.