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Pre-Qualification Worksheet

IMPORTANT INFORMATION ABOUT PROCEDURES WHEN APPLYING FOR A REAL ESTATE RELATED LOAN
To help the government fight the funding of terrorism and money-laundering activities, Federal law requires all financial institutions to obtain, verify, and record information that identifies each person who applies for credit.

What this means to you: when you apply for a loan, we will ask for your name, address, date of birth, and other information that will allow us to identify you. We may also ask to see and make a copy of your valid driver's license or other identifying documents prior to closing on your loan.

How did you hear about us?
Referred by:

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

2. Term of Mortgage Requested:   years
Type: (select one) ARM  Fixed  Undecided

3. Borrower Information:
Borrower:
 Married   Unmarried   Separated
Full Name:
First:
Middle:
Last:
Social Security Number:
  
Date of Birth (mm/dd/yyyy):
Years of School:
Number of Dependents:
Ages:
 (Use comma to separate dependents ages.)
Is this form being completed jointly or not jointly?
Co-Borrower:
 Married   Unmarried   Separated
Full Name:
First:
Middle:
Last:
Social Security Number:
  
Date of Birth (mm/dd/yyyy):
Years of School:
  
Number of Dependents:
Ages:
 (Use comma to separate dependents ages.)
NOTE:
 for Co-Borrower: Only list dependents NOT listed by borrower.

4. Borrower's Home Address:
Street:
City:
State:
Zipcode:
Do you:
 Own   Rent  Live Rent Free
Number of years at this residence:
  
Current monthly housing 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:
Zipcode:
Did you:
 Own   Rent  Live Rent Free
Number of years at this residence:
 
5. Contact Information:
Borrower
Co-Borrower
Daytime Phone:
Home Phone:
Work Phone:
Fax:
Email:
Cellular Phone:
Daytime Phone:
Home Phone
Work Phone:
Fax:
Email:
Cellular Phone:

6. Employer Information: (2 year history)
Employer Name:
Street Address:
City:
   
State:
Zip Code:
Employer Phone:

Job Title:
  
Length With Company:
years, months
Number of 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 Code:
Employer Phone:
Employed from (mm/dd/yyyy)
 to

7. Co-Borrower's Employer Information:   (2 year history)
Employer Name:
Street Address:
City:
State:
Zip Code:
Employer Phone:
Job Title:
Length With Company:
 years, months
Number of 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 Code:
Employer Phone:
Employed from (mm/dd/yyyy)
 to

8. Gross Monthly Income
List monthly income and sources of income.
Borrower
Co-Borrower
Base Empl Income:
$ $
Overtime:
$ $
Bonuses:
$ $
Commissions:
$ $
Dividends/Interest:
 $ $
Net Rental Income:
$ $
$ $
$ $
Totals:
$ $
NOTICE: Alimony, child support, or separate maintenance income need not be
revealed if it is not to be considered for repaying this loan.

9.Liabilities:
List liabilities that are not paid off on a monthly basis.
--Balance -------------Payment-------Debt Type
Creditor
$ $
$ $
$ $
$ $
$ $
$ $
$ $

10. 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


11. Are the borrowers U.S. Citizens?
Yes   No      If No, Visa Type:

12. 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


13. Are you considering a government loan?
FHA   VA  

Additional Information

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

Press the submit button once and wait for success message.

 

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