Pre-Qualification Form

Please complete the following form and we will work with
you today to help you obtain the best mortgage rate and terms.
* indicates required fields

*Borrower's Full Name:

Co-Borrower's Full Name:

Address:

*City:

*State:

  Select State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

*Zip:

Home Phone:

Work Phone:

*Email:

Best Time To Call:

---SELECT--- Afternoon at work Afternoon at home Evening at home Morning at work Morning at home

Annual Household Income:

Borrower's Current Occupation:

Years Employed There:

---SELECT--- 1 month to 1 year 1 year - 2 years 2 years -5 years 5 years -10 years Over 10 years

Co-Borrower's Current Occupation:

Years Employed There:

---SELECT--- 1 month - 1 year 1 year - 2 years 2 years -5 years 5 years -10 years Over 10 years

Credit Rating:

--SELECT-- Excellent Good Fair Poor

Property Type:

---SELECT-- Single Family Condominium Townhouse 2 Family 3 Family 4 Family Commercial/Multi Family Mixed Use Property

Purchase Price:

Current Yearly Property Tax:

Approx. Home Owner's Insurance:

Monthly Condo Fee:

*Requested Loan Amount:

Loan Purpose:

---SELECT--- Purchase New Home Refinance (Lower Rate) Refinance with Cash Out Home Improvement Loan Home equity line of credit Purchase Vacation Home Purchase Investment Property Commercial Multifamily Loan Reverse Mortgage age 62/older

If Refinancing Please Complete the Following:

Present Property Value:

Present Mortgage Type:

---SELECT--- Fixed Adjustable

First Mortgage Balance:

Second Mortgage Balance:

Present Mortgage Rate:

Current Monthly Payment:

*How Did You Hear About Us: