FHA REQUEST FORM

BranchAddress:*

Complete Property Address:*

If loan is not in a state that I am licensed in, I have read Gateway's licensing policy
and procedure and have written notification that I am able to do this loan. :* - I Agree

Sponser Name and ID:* NumberofUnits:*

Construction Status*: - Proposed UnderConstruction Rehabilitation Existing Loan Type*: - Purchase Refi If Refi, Cashout?*: - Yes No

StreamLine*: - No Yes ConvToFHA CashOut Streamline with Appraisal: - No Yes Streamline without Appraisal: - No Yes

Investment Property*: - No Yes

Mortgage Type*: - 203B(forward) HECM(reverse)

PreviousFHACase: ProjectedClosingDate:*

PUD-CondoID: MonthandYearCompleted:

AppraiserName: AppraiserLicenseNumber:

If new Construction enter Inspector Name and ID:

BorrowerName:* BorrowerSSN:* BorrowerBirthDate:*

CoBorrowerName: CoBorrowerSSN: CoBorrowerBirthDate:

Sellers: ListingAgent: SellingAgent:

TitleCompany:

LoanOfficer:*

THIS EMAIL ADDRESS MUST BE CORRECT FOR THIS FORM TO SEND!!
Contact Email:*