MortgageBanc

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	Same as Borrower's address
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:	Unknown/Same
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:

Additional Comments:

* I/We (borrower[s] named herein) understand that this form is for pre-qualification only and is not a full loan application.

Authorization to check credit verification

YES NO
By selecting "YES" to this radio button, I/WE hereby authorize lender to order a consumer credit report to verify credit and other information pertaining to pre-qualification. The information that obtains is only to be used for mortgage pre-qualification purposes.

Email Address:

Optional Information for Mortgage Planning:

This section is optional and does not affect your loan pre-qualification. The purpose of this section is to help us to better understand your specific needs & goals as they relate to your overall long & short - term financial goals.

"Most people spend more time researching the VCR or DVD player they plan to buy that they do making sure the mortgage they select is right for their specific financial needs. A DVD player costs between $100-$300 but many homeowners pay $10,000-$50,000 per year on their mortgage payments. Make sure you work with a mortgage planner who takes the time to structure your mortgage loan so that it works well with your overall financial strategy." - Barry Habib, CNBC

1. What is the best estimate for how long you might live in this home?

2. Over the next 5 years, will your household income:

3. On a scale of 1-10, how would you assess your tolerance to financial/investment risk (1 being most conservative, 10 being most aggressive)

4. Do you plan on making additional principal reduction payments in addition to your scheduled monthly mortgage payments?

5. Of the following financial goals, which would you say is a top priority currently?

		Improve Monthly Cash Flow
		Create a 6-12 Month Reserve Account
		Maximize Retirement Savings
		Maximize Education Savings
		Live Comfortably on One Income
		Maximize Asset Portfolio Performance
		Live Comfortably on a Fixed Income
		Create a Comprehensive Financial Plan

6. Which of the following is most important regarding your mortgage financing? (check all that apply)

		Minimize Monthly Payments
		Maximize Equity Accumulation (early payoff)
		Obtain cash to pay off debt, or make home improvements
		Maximize tax benefits
		Eliminate mortage insurance
		Minimize cash due at closing

7. On a scale of 1-10 (10 Being highest) how would you rate your satisfaction with the following?

1. Realtor

2.CPA

3.Financial Planner

4. Insurance Agent

Realtor-Buyer’s

Name:

Company:

Phone Number:
- -

Insurance Agent

Name:

Company:

Phone Number:
- -

Annual Hazard Ins. Premium(Fire):

Tax Consultant-Accountant

Name:

Firm:

Phone Number:
- -

Stock Broker-Fin. Planner

Name:

Firm:

Phone Number:
- -

Atlas Mortgage Inc
3000 Riverchase Galleria

Suite 750
Birmingham, AL 35242
Phone: (205) 987-5152

Toll Free (877) 987-5152
Fax: (205) 987-4637

contact us