Express Pre-Qualification Form
(highlighted fields are required)
  

 Who is your Mortgage Planner?

 Who referred you to us?

Step 1. Tell us about you.

 Borrower Information

 What is the Borrower's Name?

 First

 Middle Initial

 Last

 What is the Borrower's Current Address?

 Street

 City

 State

 

 

 Zip

 Do you rent or own?
How long (years)

 If less than 2 years, please fill out information about your previous residence.

 Street

 City

 State

 

 Zip

 What is your Social Security number and DOB?

 SSN#

 Date of Birth
(use: mm/dd/yyyy)

 What are your telephone numbers?

 Home

 Work

 Cell

 Fax

 What is your Preferred Communication?

 Co-Borrower Information (If any)

 What is the Co-Borrower's Name?

 First

 Middle Initial

 Last

 What is the Co-Borrower's Current Address (if different)?

 Street

 City

 State

 

 

 Zip

 Do you rent or own?
How long (years)

 If less than 2 years, please fill out information about your previous residence.

 Street

 City

 State

 

 Zip

 What is your Social Security number and DOB?

 SSN#

 Date of Birth
(use: mm/dd/yyyy)

 What are your telephone numbers?

 Home

 Work

 Cell

 Fax

 What is your Preferred Communication?

 

 

Who should my team and I consider as the primary contact throughout the loan process?

 

 

Step 2. Tell us about your situation.

 What is the purpose of this loan?

 If you selected "Refinance" or "Equity Repositioning", what is the type?

 What type of mortgage loan are you interested in?

 What type of Loan Program are you interested in?

 What is the length of your requested loan in months?

 If you selected "Other", please explain.

 What is the property address (if available)? [Leave blank if Equity Reposition or Refinance.]

 Street:

 City:

 State:

 Zip:

 

 Occupancy type: 

  

 

 

 What is the desired loan amount (if repositioning equity or refinancing)?

$

 If purchase, what is the estimated or desired purchase price?

$

 If purchase, what is the estimated down payment amount?

$

or %

 If purchase, where will the down payment come from?

 

 If equity reposition or refinance, what is the total owed on home?

$ 

 

Step 3. Tell us about your employment.
(need two year history)

 Borrower

 Self Employed?   Yes    No

 Employer:

 Position Title:

 How Long (Yrs/Mths):

  /

 Years in this line of work:

 If less than two years, add previous:

Employer

Position Title

 How Long (Yrs/Mths):

  /

 Co-Borrower

 Self Employed?   Yes    No

 Employer:

 Position Title:

 How Long (Yrs/Mths):

  /

 Years in this line of work:

 If less than two years, add previous:

Employer

Position Title

 How Long (Yrs/Mths):

  /

 

 

Gross Monthly Income
(please separate Borrower and Co-Borrower)

Borrower

Co-Borrower

Base Empl Income

$

$

Overtime

$

$

Bonuses

$

$

Commissions

$

$

Dividends/Interest

$

$

Net Rental Income

$

$

$

$

$

$

Step 4. Tell us about your assets/liabilities.

 Borrower Assets

Amount

Source

Institution

 

 

  Liabilities

Debt Type

Creditor

Payment

Balance

 

 

 

Other Information

 Which best describes your situation? (feel free to use both drop downs)

 How would you rate your credit? (Rate 1 to 5, "1" being most challenging, "5" being excellent).

 

Are all borrowers US Citizens?

Is either borrower self-employed, own 25% or more of a corporation, or derive 25% or more of income from commissions?

 

  I am working with a real estate agent.
  Yes    No
 

Agents Name:

Company:

Phone Number: