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Loan Pre-Qualifying Application

Referred by:
Borrower Name:
Borrower S/S Number:
Co-Borrower Name:
Co-Borrower S/S Number:
Address:
City:
County:
State:
Zip:
Home Phone:
Day Phone:
E-Mail Address:
What is Value of Property?:
Property Type:
Property Status:
Purpose of Loan:
If Refinance, the reason?:
Current 1st Loan if Refinance:
Current 1st Prepay Penalty?:
Current Interest Rate 1st Loan:
Current Payment 1st Loan:
This Payment Includes:
Principle
Interest
Tax (escrow/impounds)
Insurance (escrow/impounds)
Not Sure
Current 2nd Loan if Refinance:
Current 2nd Prepay Penalty?:
Current Interest Rate 2nd Loan:
Current Payment 2nd Loan:
Credit Status:  Excellent
 Good
 Fair
 Poor
Borrower Employer:
Borrower Employer Address:
Borrower Employer City:
Borrower Employer State:
Borrower Employer Zip:
Borrower Employer Phone:
Borrower Monthly Income:
Borrower Years at Current Job:

Co-Borrower Employer:

Co-Borrower Employer Address:
Co-Borrower Employer City:
Co-Borrower Employer State:
Co-Borrower Employer Zip:
Co-Borrower Employer Phone:
Co-Borrower Monthly Income:
Co-Borrower Years at Current Job:

Borrower Self Employed:
Bor Self-Empl'd Monthly Income:
Borrower Years Self-Employed:

Co-Borrower Self Employed:
Co-Bor Self-Empl'd Monthly Income:
Co-Borrower Years Self-Employed:

Loan Amount Requested:
What Do You Wish to Accomplish/Comment On:

In order to Pre-Qualify me/us for a mortgage loan, I/We authorize you to order a credit report