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Purpose:
  Pre-approval
  Seeking general information

This mortgage is for:
  Purchase
  Refinance

Is this for your primary residence?
  Yes
  No

Your current address:
Address
 
City
State/Province
Zip/Postal
Daytime Telephone
Evening Telephone
E-mail
Fax

How long have you been at this address?

Do you currently:
  Rent
  Own

What is your monthly payment?

BORROWER

Name of Borrower:
First: 

Last: 

Age:

Marital Status
  Married
  Separated
  Unmarried (single, divorced or widowed)

Years in School:

Number of Dependants:

Dependants Ages:

Employers Name:

Your Job Position:

Work phone number:

Are you self employed?
  Yes
  No

How long have you been on this job?
  Years
  Months

Your gross monthly income:

Additional sources of income:

Amount of additional income per month:

CO-BORROWER

Name of Co-Borrower:
First: 

Last: 

Age:

Marital Status
  Married
  Separated
  Unmarried (single, divorced or widowed)

Years in School:

Number of Dependants:

Dependants Ages:

Employers Name:

Your Job Position:

Work phone number:

Are you self employed?
  Yes
  No

How long have you been on this job?
  Years
  Months

Your gross monthly income:

Additional sources of income:

Amount of additional income per month:


If Co-borrower is at a different address than Borrower:

Your current address:
Address
 
City
State/Prov.
Zip/Postal
Day Phone
PM Phone
E-mail
Fax

How long have you been at this address?

Do you currently:
  Rent
  Own

What is your monthly payment?


Assets: (check which ones will be used for home purchase)
Checking
Savings/CDs
Retirement
Mutual fund
Stocks/bonds
Other
Gift

Debts:
Creditor Monthly payment Balance

Do you own other real estate?
  Yes
  No

If yes:
Address
 
City
State/Province
Zip/Postal
Mortgage balance
Payment
Value
Property type: (2nd home, investment, etc.)

What is your purchase price range?
  From $ to $

What is the maximum you want your payment to be?
  $

Please add any information or comments that may help us obtain your loan approval:

Authorization to Release Income Information

I Agree I Do Not Agree

 

 
 
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