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PRE-QUALIFY LOAN APPLICATION

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General Information

Borrower Co-borrower
(If different)
Full Name:
Address:
City, State, Zip
Home Phone:
Work Phone:
Best time to contact:
E-mail:
Social Security #:
Employers:
Are you self employed ? Yes No Yes No
Length of Employment:
Gross Monthly Income:
My credit history is: excellent
good, but some lates
some credit problems
major credit problems
don't know 		excellent
good, but some lates
some credit problems
major credit problems
don't know

Loan Request

Amount Requested:
Type of loan:

Property Information

(This information needs to be filled out for property that is collateral for the loan)

Street Address:
City, State, Zip Code:
Estimated Present Value:
Year Purchased:
Original Price:
Type of Property: Primary Second/Vacation Investment
Purchase Amount:

Loan Information

Mortgage Balances Amount:
First:
Second:
Other:
Creditors Amount Owed Monthly Payment Will you pay this off ?
$ $ Yes No
$ $ Yes No
$ $ Yes No
$ $ Yes No

Other monthly debts and information - please describe


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