Ivanhoe Financial, Inc.

Lock-In/Register
Ivanhoe Loan # (if assigned)	Registration New Lock Re-Lock Change

Borrower Information
Last Name
First Name
Social Security #

Co-Borrower Information
Last Name
First Name
Social Security #

Property Address
Address
City State Zip

Program Information
Program Name	Program Code
Property Type	Number of Units

Occupancy Owner Occupied Second Home Investment	Purpose of Loan Purchase Refi-Cash Out Refi-Rate/Term Construction/Perm

Loan Amount	Term
Buydown Yes No	LTV CLTV
2nd Mortgage Amount Sales Price	Appraised Value

If FHA / VA
Base Loan Amount	FHA MIP / VA FF

If ARM
Margin	Caps

Lock-In Request
Interest Rate	Net Points

Estimated Closing Date	Lock-In Period 15 Day 30 Day 45 Day 60 Day

Extended Lock? Yes No (Upfront Fee Required)	Escrow Waived? Yes No (Additional .25 Pt. Cost)

Broker Information*
Company
Address
City State Zip
Contact Name
Loan Officer Name
Phone Number	Fax Number
Email Address
Specialty / Alt. Plus Programs
Only required when program price adjustment applies from rate sheet
Documentation Type Full/Alt. Stated Inc. No Ratio NI/NA	Property Type Condo CondoHotel Non-Warrantable PUD
Foreign National	Credit Score
Notes

Disclaimer: Please do not consider submission of this form as confirmation that your loan is locked in/registered. Your confirmation will be faxed to you within 24 hours. Only when you receive your faxed confirmation should you consider your loan to be locked-in/registered. * Required Fields

Equal Housing Lender