A mortgage loan questionnaire is a list of questions asked to a borrower by a lender where the respondent has to formally give information about his personal and financial details so that the lender is convinced that the borrower has a financial plan or goal and he can also expect to get his money back.

A mortgage loan questionnaire is also used to create an application which is filled up by a respondent while applying for a housing loan describing the mortgage amount, term, details of the property, source of payment, amount of payment and other information about the borrower. The completed questionnaire serves as a record for both parties.

Sample Mortgage Loan Questionnaire:

Please provide the following borrower details below:

a) Name: _____________________

b) Date of Birth: ____/____/____

c) Address: Street: ____________ City: ___________, State: ___________, ZIP Code: _____________

d) Working Phone Number: ______________

e) Social Security number:

f) Email Address: _____________________

1. What is your marital status?

a) Married

b) Unmarried

c) Separated

2. Do you have any dependents? If yes, how many and what is their age? ________

3. What kind of loan are you applying for?

a) Federal Housing Authority Loan

b) Veterans Administration Loan

c) Conventional Loan

4. Please specify the mortgage amount: ___________

5. What is the mortgage term with reference to this loan? ________

6. Are you opting for a fixed rate of amortization or an ARM? _________

7. Please give the address of the property you are buying:

Street Address: ____________ City: ___________, State: ___________, ZIP Code: _____________

8. What will you be using the property mentioned above for?

a) Primary residence

b) Secondary residence

c) Investment property

9. What will be the amount of down payment and what is the source of down payment? __________

10.  Under whose name will the title be held? __________