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Mortgage Pre-qualification Form (100%)

Please submit the information requested below. By filling out this application you are giving permission for our preferred lender to pull credit. We will make every effort to respond within 48 hours.

Step 1 of 4

By filling out this form do you give permission for our preferred lender to pull BORROWER/CO-BORROWER Credit?*
Type YES in the box above if you agree
Borrower Name
First Last
Date of Birth:
Social Security No.
Mobile Phone #:
Home Phone #:
Work Phone #:
Email Address:
- Rent
- Own
Current Address:
Street Address City State ZIP Code
How long (yr):
Prior Address (if less than 2 years)
Street Address City State ZIP Code
Current Monthly Payment:
Current Employer:
How long (yr):
Position:
Salary/Wages
Prior Employer (if less than 2 years)

Financial Information
Total savings in bank accts:
Gross monthly income:
Other monthly income:
Source of other income?:
Household Size:
(If you answer “yes” to any question below, PLEASE provide a detailed explanation)
Have you had a Foreclosure in the past 7 years?
- Yes
- No
Explanation:
Explain any credit issues:
Explain any collections liens judgements:

Co-Borrowers Information
Co-Borrower Name
First Last
Date of Birth:
Social Security No.
Mobile Phone #:
Home Phone #:
Work Phone #:
Email Address:
- Rent
- Own
Current Address:
Street Address City State ZIP Code
How long (yr):
Prior Address (if less than 2 years)
Street Address City State ZIP Code
Current Monthly Payment:
Current Employer:
How long (yr):
Position:
Salary/Wages
Prior Employer (if less than 2 years)

Co-Borrower Financial Information
Total savings in bank accts:
Gross monthly income:
Other monthly income:
Source of other income?:
Household Size:
(If you answer “yes” to any question below, PLEASE provide a detailed explanation)
Have you had a Foreclosure in the past 7 years?
- Yes
- No
Explanation:
Explain any credit issues:
Explain any collections liens judgements:
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Mortgage Pre-qualification Form (100%)

Step 1 of 4

Financial Information

(If you answer “yes” to any question below, PLEASE provide a detailed explanation)

Co-Borrowers Information

Co-Borrower Financial Information

(If you answer “yes” to any question below, PLEASE provide a detailed explanation)

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