Pre-Qualification Worksheet

* Required Field

How did you hear about us?
Referred by:

1. Property Information:
    Select one:
    No Property  Offer Pending  Under Contract
    If "Under Contract", enter closing date (mm/dd/yyyy):

    Property Address:
    Street:
    City:   State:   ZIP:

    This home will be: (select one)
    Primary Residence  Second Home  Investment Property

    Proposed Purchase Price: (If Construction - Total Project)

2. Down Payment:
Specify either dollar amount or percentage of purchase price
or %
Down Payment will come from:
(Please specify: checking, savings, investment account, sale of stock, sale of home, 401K loan, gift, etc.)

3. Term of Mortgage Requested:
 Years
Type: (select one)
ARM  Fixed  Undecided

4. Title to be held in the name(s) of:

5. Borrower Information:

    Married   Unmarried
    * First Name:   Middle:   * Last:
    Date of Birth (mm/dd/yyyy):
    Years in School:
    Number of Dependents:
Co-Borrower:
    Married   Unmarried
    First Name:   Middle:   Last:
    Date of Birth (mm/dd/yyyy):
    Years in School:
    Number of Dependents:

6. Borrower's Home Address
* Street:
* City:   * State:   * ZIP:

Do you: Own   Rent   Live Rent Free
# of Years at this residence?
* Current monthly Mortgage payment:
* Current monthly Property Tax payment:
* Current monthly Hazard Insurance payment:
Do you intend to sell current home? Yes   No
Current home listed for sale? Yes   No
Estimated Market Value:
Under Contract? Yes   No

If less than a 2 year history at current address, please fill out information about previous address:
    Street:
    City:   State:   ZIP:

    Did you: Own   Rent   Lived Rent Free
    # of Years at this residence?
If renting, please complete the following:
    Landlord's First Name:
    Landlord's Last Name:
    Landlord's Phone Number:

7. Contact Information
Borrower Co-Borrower
* Home Phone:
Work Phone:
Cell Phone
FAX:
* E-mail:
Home Phone:
Work Phone:
Cell Phone
FAX:
E-mail:

8. Employer Information: (2 year history)

    Employer Name:
    Street Address:
    City:   State:   ZIP:
    Employer Phone:
    Job Title:  
    Years, Months with current employer.
    # Years at this type of work:
    Corporate Relocation? Yes   No  
    Are you self-employed? Yes   No  

If less than 2 year history at current job, fill out for previous employer

    Employer Name:
    Street Address:
    City:   State:   ZIP:
    Employer Phone:
    Employed from (mm/dd/yyyy) to

9. Co-Borrower's Employer Information: (2 year history)

    Employer Name:
    Street Address:
    City:   State:   ZIP:
    Employer Phone:
    Job Title:  
    Years, Months with current employer.
    # Years at this type of work:
    Corporate Relocation? Yes   No  
    Are you self-employed? Yes   No  

If less than 2 year history at current job, fill out for previous employer

    Employer Name:
    Street Address:
    City:   State:   ZIP:
    Employer Phone:
    Employed from (mm/dd/yyyy) to
10. List monthly income and sources of income.
Gross Monthly Income Borrower Co-Borrower
* Base Employee Income
Overtime
Bonuses
Commissions
Dividends/Interest
Net Rental Income
Totals:


11. List primary assets such as bank (checking, savings, IRA), investment, retirement accounts, stock options, real estate.
Assets Source Name of Institution


12. List liabilities that are not paid off on a monthly basis.
Liabilities Source
Balance Payment Debt Type Creditor

13. Are there any judgments, lawsuits, bankruptcy (last 10 years), foreclosures, alimony, child support, or indirect credit obligations (guarantees or co-signing) we should be aware of?
Yes  No

If "Yes", please describe:


14. Are the borrowers...
* U.S. Citizens? Yes  No

If "No", Visa Type:

15. Do you own 25% or more of any Corporation or Partnership, or derive 25% or more of your income from commissions?
Yes   No

If "Yes", please describe:


16. Are you applying for a government loan?
FHA   VA  


Any Additional Information:

NOTE: Please print a copy for your file before submitting.