Apply for a Loan

This form is designed to provide us with the basic information we may need to pre-qualify you for a home mortgage with our company. WE DO NOT WANT YOUR SOCIAL SECURITY NUMBER . A loan officer will be in touch with your by phone within 24 hours. (This is for safety reasons) If you have any questions about this form please contact us. Thanks!

SHORT FORM PRE-QUALIFICATION LOAN APPLICATION

Information about yourself:

Full Name
Street Address
City
State Zip
E-mail (required)
Telephone #
Other #

What would you like to do today?

Purchase
Refinance

Property Information:

Street Address
City
State Zip

Property Type:

Purchase Price
Est - Value
Down Payment
Loan Amount

INCOME AND EXPENSES

Total Monthly Income:

Gross/Income
Other

Total Monthly Debt Payments:

Total Pmt:

Monthly debt includes items you are paying on such as credit cards, automobiles, loans, etc. It should not include utilities (lights, gas).

COMPLETE NEXT SECTION IF THIS IS A REFINANCE

Existing Mortgage Information:

1st mtg amount		Loan Type:
2nd mtg amount		Loan Type:

If you have an adjustable, what is your Index? Current Rate?

If you have an adjustable, what is your Life Cap? Date of Next Adjustment

Purpose of Refinance?

OTHER INFORMATION

Which best describes your current situation?

I have found a Realtor!

Agents Name
Company
Phone #

I need a Realtor! Please have one contact me as soon as possible!

Additional Comments:

Authorization to check credit verification
By selecting this check box, I hereby authorize the lender to order a consumer credit report and verify other credit information. The information that the lender obtains is only to be used in the processing of my application for a mortgage loan, or in the quality control review of my loan.