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Prequalification Form
  I am applying to borrow $
Loan Type
Purpose of Loan:

Address of Property you are purchasing:
[If you have a property currently under contract]
Sales Price: $
Property will be:
Term:
30 Years
15 Years


Fixed Adjustable
Real Estate:


Do you currently own a primary residence?
Yes
No
If yes, is it to be sold?
Yes
No


Do you own a second home or any rental properties?
Yes
No
If yes, how many?
Current debt structure
(Please enter minimum monthly payment.)

Rent:
Mortgage:
Car:
Loans:
Visa:
Mastercard:
Discover:
American Express:
Student Loan:
Other:
Other:
Other: 		  $
$
$
$
$
$
$
$
$
$
$
$
Comments:
Borrower Information
Name:

Social Security #:

Phone [Daytime]:

Phone [Evening]:


May we call you at your daytime number?
Yes
No


Best time to call:


Date of Birth:

Present Street Address:

City:

State and Zip Code:

E-Mail Address: (required)

Employer:

City and State:

Your Position or Job Title:

Gross Yearly Income:
Co-Borrower Information
Name:

Social Security #:

Phone [Daytime]:

Phone [Evening]:


May we call you at your daytime number?
Yes
No
Best time to call:


Date of Birth:

Present Street Address:

City:

State and Zip Code:

E-Mail Address:

Employer:

City and State:

Your Position or Job Title:

Gross Yearly Income: