Fill out this form for Mortgage Pre-Qualification
APPLICATION FOR NEW PURCHASE INCLUDING BRAND NEW HOMES
Primary Applicant
First Name: Middle Initial: Last Name:
Street Address: Apt #:
City: State: Zip Code:
Home Phone: Work Phone:
e-mail address
(e.g.; xxx@yyy.zzz)
Social Security Number:
Employers' Name: Employers' Phone Number: Are you self employed ? Yes
No
Length of Employment: Monthly Income (Before Taxes)*:
Co-Borrower
First Name: Middle Initial: Last Name:
Street Address: Apt #:
City: State: Zip Code:
Home Phone: Work Phone:
Social Security Number:
Employers' Name: Employers' Phone Number: Are you self employed ? Yes
No
Length of Employment: Monthly Income (Before Taxes)*:
Loan Request
Purpose of the Loan:
I am interested in a loan some time in the future. Please keep me informed. I am interested in buying a home and I would like to find the loan I can qualify for. I want to get prequalified so that I can let a RealtorŪ know what I can afford.
I have found a home and I am ready to make an offer. I have a signed sales agreement. I am interested in refinancing my current home.
I own a home and I am interested in a 2nd mortgage.
How much of a down payment
do you have available?
Purchase Price: Loan Amount Requested:
Type of Loan:
30 Year Fixed 5 Year Fixed Payment MTA-ARM (Qualify at initial offered Rate & Enjoy small Payments)
15 Year Fixed 10 Year Fixed Payment MTA-ARM (Qualify at initial offered Rate & Enjoy small Payments)
VA - 30 Year Fixed FHA - 30 Year Fixed 1st Time Buyer - Help me select A Program
Apartment Building Loan Shopping Center-Commercial Loan Small Business Loan (SBA)-With Building
Property Information
(Collateral property for the loan)
Street Address: City, State, Zip Code:
Present Value:(Estimate) Property Tax: Original Price:
Year Purchased: Type of Property: Primary       Second/Vacation       Investment
Loan Information
Mortgage Balance(s) (Refinance Only)
First: Held by: Payment:
Second: Held by: Payment:
Other: Held by: Payment:
Creditor(s)
1. Creditor Amt Owed: Mo. Payment:
Will This Debt Be Paid Off? Yes No
2. Creditor Amt Owed: Mo. Payment:
Will This Debt Be Paid Off? Yes No
3. Creditor Amt Owed: Mo. Payment:
Will This Debt Be Paid Off? Yes No
4. Creditor Amt Owed: Mo. Payment:
Will This Debt Be Paid Off? Yes No
Any other debts we should know about? - Please describe below

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