This is the Application Disclaimer.
PRE-QUALIFICATION APPLICATION
1. Let's Get Acquainted
First Name * Last Name *
Telephone (Hse) * Telephone (Bus)
Email * Fax
Loan Consultant
2. Type of Mortgage and Terms of Loan
Loan Amount:
3. Property Information and Purpose of Loan
Purpose of Loan:
Property Will Be:
Purchase Price or Estimated Value:
Source of Down Payment, Settlement Charges, and/or Subordinate Financing:
4a. Borrower Information Same as Applicant
First Name: *
Last Name: *
Social Security Number:
Evening Phone:
Marital Status:
Number of Dependents:
(Count shared dependents once)
Date of Birth:(MM/DD/YYYY) *
Email Address: *
Present Address
Street:
City:
State:
ZIP Code:
Rent or Own?
How Long at Address:  years    months
Complete the following if at present address less than two years:
Former Address
Street:
City:
State:
ZIP Code:
Rent or Own?
How Long at Address:  years   months
4b. Co-borrower Information
First Name:
Last Name:
Social Security Number:
Evening Phone:
Marital Status:
Number of Dependents:
(Count shared dependents once)
Date of Birth:(MM/DD/YYYY)
Present Address ( Same as Borrower )
Street:
City:
State:
ZIP Code:
Rent or Own?
How Long at Address:  years   months
Complete the following if at present address less than two years.
Former Address ( Same as Borrower )
Street:
City:
State:
ZIP Code:
Rent or Own?
How Long at Address:  years  months
5. Monthly Income and Combined Housing Expense Information
GROSS MONTHLY INCOME BORROWER CO-BORROWER
Base Empl. Income:
Overtime
Bonusus
Commisssions
Dividends/Interest:

Describe Other Income: Notice: Alimony, child support, or separate maintenance need not be revealed if you do not choose to have it considered for repayment of this loan.
  Owner Description Monthly Amount
#1 BORROWER
#2 BORROWER
#3 BORROWER
#4 CO-BORROWER
#5 CO-BORROWER
#6 CO-BORROWER
     
Combined Monthly Housing Expense Where You Live Now Proposed Loan
Rent:  
First Mortgage (P&I):
Other Financing (P&I):  
Hazard Insurance:
Real Estate Taxes:
Mortgage Insurance:
Homeowner Assn. Dues:

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