Pre-Qualification Request Form
Contact Information
Name: Home Phone: Work Phone: Fax: E-mail:
Loan Request
Purchase Refinance Home Improvement Other, please describe:
Loan Amount
Loan amount desired is $
What state are you planning to purchase, refinance or mortgage in?
Type of Loan
Fixed Rate Mortgage Adjustable Rate Mortgage Two-Step / Balloon Mortgage Haven't decided Other, please state:
Personal Information
Annual household income is $ Monthly debt (Credit Cards, Loans, Leases, etc.) is $ Rate your credit history (A=excellent) A B C D
Please fill out :
When finished click on the send button.
PURCHASE SECTION
FILL THIS OUT IF PURCHASING A HOME
Please skip to the next section if refinancing
TimeFrame
Thinking about it Actively Looking About to make an offer Have a sales contract
Realtor Information
I am working with a Realtor Please refer me to a Realtor I am buying directly from the seller I am buying directly from the builder
Purchase Price
I expect to buy a home between $ and $
Down Payment
I expect to put between % and % down
REFINANCE SECTION
FILL THIS OUT ONLY IF REFINANCING
Please skip to the next section if applying for a second mortgage
Property Value
The property should appraise for $ Year Purchased Purchase Price $
Existing loans / liens / judgements on property
1st loan balance $ 2nd loan balance $ 3rd loan balance $
Reason for Refinancing
Reduce Interest rates Change from fixed to adjustable Change from adjustable to fixed Need cash out. Cash out required $ Other, please specify:
Current loan type
Fixed Adjustable Other, please specify:
