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Pre-Qualify Mortgage Form

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Pre-Qualify Mortgage Form

Referred By
Mortgage Loan Originator
First Name *
Last Name *
Birth Date *

Month

Day

Year
Email Address *
Best Contact Number *
-
Area Code     Phone Number
Current Residence Address *
City *
State *
Zip Code *
Do you rent or own currently?
Rent
Own
If you own, what will you be doing with your primary residence?
Selling it
Renting it
I'm keeping it and purchasing a 2nd home
I'm keeping it and buying a rental property
How long have you lived at your current residence?
Current Monthly Rental Payment (If Applicable)
Previous Residence Address (If Less Than 2 Years)
APT Number
City
State
Zip Code
Current Employer
Employer Phone Number
-
Area Code     Phone Number
Employer Address
City
State
Zip Code
Years at Employer
Gross Monthly Income (Before Taxes)
Position
How do you get paid?
Hourly
Salary
Commission
Additional Income
Commission
Bonus
Are you Self Employed? (This includes 1099 employees)
Yes, Self Employed
No, I receive a W2
Are you obligated to pay court ordered alimony or child support?
(If Yes) How much are you obligated to pay monthly?

Client #2 (If Two Buyers Are Financing)

First Name
Last Name
Birth Date

Month

Day

Year
Email Address
Best Contact Number
-
Area Code     Phone Number
Home/Cell Number
-
Area Code     Phone Number
Address
APT Number
City
State
Zip Code
Current Employer
Employer Phone Number
-
Area Code     Phone Number
Employer Address
City
State
Zip Code
Years at Employer
Gross Monthly Income (Before Taxes)
Position
How do you get paid?
Hourly
Salary
Commission
Additional Income
Commission
Bonus
Are you Self Employed? (This includes 1099 employees)
Yes, Self Employed
No, I receive a W2
Are you obligated to pay court ordered alimony or child support?
(If Yes) How much are you obligated to pay monthly?

Finalize Application (Combined Information)

Account #1
Checking
Savings
Money Market
Avg monthly balance
Retirement Account Total Vested Amount
Account #2
Checking
Savings
Money Market
Avg monthly balance
CD / Total Amount
Account #3
Checking
Savings
Money Market
Avg monthly balance
What is the maximum monthly mortgage payment that you are comfortable with? (This includes Property Taxes and Mortagage Insurance) This will help us determine your maximum pre-approved price range.
Please feel free to list any additional comments below
* To reduce SPAM, please answer the question below.
Name a state, in the United States, that starts with the letter 'F'.
NMLS# 326484

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