JMS Mortgages Inc. Application Form

Lexon Mortgages Plus Broker License: 12768

Please fill out the entire form as detailed as possible before you click submit at the bottom of the page.


    Main Applicant







    Financial Net Worth $



    Liabilities Total Debt


    Liabilities Monthly Payment



    Property Description



    Existing Mortgage/Properties

    First Mortgage


    Second Mortgage


      I/We warrant and confirm that the information given in the mortgage application form is true and correct and I/We understand that it is being used to determine my/our credit responsibility. Lexon Mortgages Plus is authorized to obtain any information you may require relative to this application from any sources to which you may apply and each such source is hereby authorized to provide you with such information. Lexon Mortgages Plus is furthermore authorized to disclose, in response to direct inquiries from any other lender or credit bureau, such information on my loaning accounts as you consider appropriate, and I agree to indemnify Lexon Mortgages Plus against and save you harm from any and all claims in damages or otherwise arising from such disclosure on your part. Lexon Mortgages Plus is also authorized to retain the application whether or not the relative mortgage is approved.