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Section A: Mortgage Lates

Within the last 24 months have you had any late payments on your mortgage?

If yes, continue, otherwise skip to section B.

Number of Mortgage Lates

Within the last 12 months

Between 13 and 24 months ago

30-59 days late

60-89 days late

90+ days late

Are you currently late on your mortgages?

Section B: Consumer Loan Lates

Have you had any late payments on your credit cards, auto loans, student loans or any other consumer debts?

If yes continue, otherwise skip to section C.

Number of Consumer Lates

Within the last 12 months

Between 13 and 24 months ago

30-59 days late

60-89 days late

90+ days late

Are you currently late on your consumer loan payments?

Section C: Collections, Charge offs, Judgements, Tax Lien

Do you have any collections, charge offs, judgements or tax liens?

Section D: Bankruptcies

Have you been bankrupt during the last 7 years?

Section E: Foreclosures

Have you had any foreclosures during the last 7 years?

Section F: Payment load

Do you have a lot of consumer debts, such as credit cards, auto loans, student loans, etc.?

Section G: Equity in your property

The value of my house is $
The total amount of loans on my house are $

Anasazi Mortgage - 460 St. Michael's Dr. Suite 601 - Santa Fe, NM 87505
Office Phone: (505) 995-8888 Fax: (505) 995-8885 Toll-free Phone: 800-995-8888 (if calling outside of Santa Fe)

We are a New Mexico owned and operated mortgage broker, specializing in personalized, competent mortgage advice directly to the borrower. We are not a lead collector, nor do we sell, rent or otherwise share your personal information with any other entity. We look forward to serving your mortgage needs.

Equal Housing Lender

NAMB - National Association of Mortgage Brokers