Pre-Qualification Form BorrowerFirst Name* Middle Initial Last Name* DOB Month*DOB Month :JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecemberDOB Day*Day :01020304050607080910111213141516171819202122232425262728293031DOB Year*Year :201720162015201420132012201120102009200820072006200520042003200220012000199919981997199619951994199319921991199019891988198719861985198419831982198119801979197819771976197519741973197219711970196919681967196619651964196319621961196019591958195719561955195419531952195119501949194819471946194519441943194219411940193919381937193619351934193319321931Social Security Number Email* Cell Phone Number...*Address* HiddenUnit TypeUnit Type...ApartmentBasementBuildingCondoDepartmentFloorFrontHangerKeyLobbyLotLowerOfficePenthousePierRearRoomSideSpaceStopSuiteTrailerUnitUpperUnit # City* State*State...AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificZip* How Long At Current AddressHow Long At Current Address1 Year2 Years3 Years4 Years5 Years6 Years7 Years8 Years9 Years10 Years11 Years12 Years13 Years14 Years15 Years16 Years17 Years18 Years19 Years20 Years21 Years22 Years23 Years24 Years25 Years26 Years27 Years28 Years29 Years30 YearsLiving Status at AddressLiving Status At AddressOwnRentLiving Rent FreeLoan OfficerLoan Offiecer selectbox*Please Select Your Loan OfficerI do not have one yetIncome Notice: Alimony, Child Support Or Separate Maintenance Income Need Not Be Revealed If The Borrower Or Co-Borrower Does Not Choose To Have It Considered For Repaying This loan.Gross Monthly Income Source of Additional IncomeAlimonyAutomobile AllowanceBoarder IncomeCapital GainsChild SupportDisabilityFoster CareHousing or ParsonageInterest and DividendsMortgage Credit CertificateMortgage Differential PaymentsNotes ReceivablePublic AssistanceRetirement (e.g., Pension, IRA)Royalty PaymentsSeparate MaintenanceSocial SecurityTrustUnemployment BenefitsVA CompensationOtherEmployment SectionEmployment StatusEmployment StatusEmployedSelf EmployedName Of Employer How Many YearsHow Many Years123456789101112131415161718192021222324252627282930How Many MonthsHow Many Months123456789101112AssetsChecking Savings Retirement Funds Other Assets Additional Real Estate OwnedDo You Own Additional Real EstateDo You Own Additional Real Estate?YesNoHow Many PropertiesHow Many Properties12345678910Additional DetailsMarital StatusMarital StatusUnmarriedMarriedSeparatedDo you pay child support or alimonyDo You Pay Child Support Or Alimony?YesNoHow Much Per Month Is This a Purchase or RefinanceIs This A Purchase Or Refinance?PurchaseRefinanceAre You a VeteranAre You a Veteran?YesNoHow Many DependentsHow Many Dependents?12345678910Age of DependentAge Of Dependent0123456789101112131415161718Age of DependentAge Of Dependent0123456789101112131415161718Age of DependentAge Of Dependent0123456789101112131415161718Age of DependentAge Of Dependent0123456789101112131415161718Age of DependentAge Of Dependent0123456789101112131415161718Age of DependentAge Of Dependent0123456789101112131415161718Age of DependentAge Of Dependent0123456789101112131415161718Age of DependentAge Of Dependent0123456789101112131415161718Age of DependentAge Of Dependent0123456789101112131415161718Age of DependentAge Of Dependent0123456789101112131415161718Childcare Expenses Monthly First Time Home BuyerFirst Time Home Buyer?YesNoCo-Borrower Click here if you have a Co-Borrower Click here if you have a Co-Borrower First Name* Middle Initial Last Name* DOB Month*DOB Month :JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecemberDOB Day*Day :12345678910111213141516171819202122232425262728293031DOB Year*Year :201720162015201420132012201120102009200820072006200520042003200220012000199919981997199619951994199319921991199019891988198719861985198419831982198119801979197819771976197519741973197219711970196919681967196619651964196319621961196019591958195719561955195419531952195119501949194819471946194519441943194219411940193919381937193619351934193319321931Social Security Number Email* Cell Phone Number...*Click Here If Address is Same as Above Click Here If Address is Same as Above Address* HiddenUnit TypeUnit Type....ApartmentBasementBuildingCondoDepartmentFloorFrontHangerKeyLobbyLotLowerOfficePenthousePierRearRoomSideSpaceStopSuiteTrailerUnitUpperUnit# City* State*State...AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificZip* How Long At Current AddressHow Long At Current Address1 Year2 Years3 Years4 Years5 Years6 Years7 Years8 Years9 Years10 Years11 Years12 Years13 Years14 Years15 Years16 Years17 Years18 Years19 Years20 Years21 Years22 Years23 Years24 Years25 Years26 Years27 Years28 Years29 Years30 YearsLiving Status at AddressLiving Status At AddressOwnRentLiving Rent FreeIncomeNotice: Alimony, Child Support Or Separate Maintenance Income Need Not Be Revealed If The Borrower Or Co-Borrower Does Not Choose To Have It Considered For Repaying This Loan.Gross Monthly Income Source of Additional IncomeAlimonyAutomobile AllowanceBoarder IncomeCapital GainsChild SupportDisabilityFoster CareHousing or ParsonageInterest and DividendsMortgage Credit CertificateMortgage Differential PaymentsNotes ReceivablePublic AssistanceRetirement (e.g., Pension, IRA)Royalty PaymentsSeparate MaintenanceSocial SecurityTrustUnemployment BenefitsVA CompensationOtherEmployment SectionCo Bro Employment StatusEmployment StatusEmployedSelf EmployedCo Bro Name of Employer Co Bro How Many Years employeeHow Many Years123456789101112131415161718192021222324252627282930Co Bro How Many Years self employeeHow Many Years123456789101112131415161718192021222324252627282930Co Bro How Many Months employeeHow Many Months123456789101112Co Bro How Many Months self employeeHow Many Months123456789101112AssetsCo Bro Checking Co Bro Savings Co Bro Retirement Funds Co Bro Other Assets Additional Real Estate OwnedCo Bro Do You Own Additional Real EstateDo You Own Additional Real Estate?YesNoCo Bro How Many PropertiesHow Many Properties12345678910Additional DetailsCo bro Marital StatusMarital StatusUnmarriedMarriedSeparatedCo Bro Do you pay child support or alimonyDo You Pay Child Support Or Alimony?YesNoCo Bro How Much Per Month Co Bro Are You a VeteranAre You a Veteran?YesNoHow Did You Hear About Us?How did you hear about usHow Did You Hear About Us?OtherInternetFriendRealtorBuilderFriend Name Friend Cell Phone NumberRealtorName Realtor Cell Phone NumberBuilder Name Builder Cell Phone NumberAuthorizationBorrower Authorization Checkbox* Borrower Signature I understand that by submitting this online application, I am authorizing a credit check and to make whatever inquiries necessary in connection with this request.Upload borrower digital signature Click Here If You Want To Upload Digital Signature Signature*For easier signing please turn the phone sideways.Borrower digital signature upload*Accepted file types: jpg, png, jpeg, Max. file size: 3 MB.Co-Borrower Signature BelowCo Borrower Authorization Checkbox Check here if co-borrower is not present to sign the digitial signature. Chk Co borrower upload digital signature Click Here If You Want To Upload Digital Signature Please Provide Your Co-Borrower Digital Signature:Co Signature*For easier signing please turn the phone sideways.Co borrower digital signatureAccepted file types: jpg, png, jpeg, Max. file size: 3 MB.Co-Borrower signature Email Co-Borrower Cell Phone Number*Info For Government The following information is requested by the Federal Government for certain types of loans related to a dwelling in order to monitor the lender's compliance with equal credit opportunity, fair housing and home mortgage disclosure laws. You are not required to furnish this information, but are encouraged to do so. The law provides that a Lender may not discriminate either on the basis of this information, or on whether you choose to furnish it. If you furnish the information, please provide both ethnicity and race. For race, you may check more than one designation. If you do not furnish ethnicity, race, or sex, under Federal regulations, this lender is required to note the information on the basis of visual observation and surname if you have made this application in person. If you do not wish to furnish the information, please check the box below. Borrower Ethnicity: Check one or more Hispanic or Latino Mexican Puerto Rican Cuban Other Hispanic or Latino - print origin For example: Argentinean, Colombian, Dominican, Nicaraguan, Salvadoran, Spaniard, And So On. Not Hispanic or Latino I do not wish to provide this information Race: Check one or more American Indian or Alaska Native - Print name of enrolled or principal tribe: Asian Asian Indian Chinese Filipino Japanese Korean Vietnamese Other Asian - Print race: For example: Hmong, Laotian, Thai, Pakistani, Cambodian, And So On. Black or African American Native Hawaiian or Other Pacific Islander Native Hawaiian Guamanian or Chamorro Samoan Other Pacific Islander - Print race: For example: Fijian, Tongan, And So On. White I do not wish to provide this information Sex Male Female I do not wish to provide this information Co-Borrower Ethnicity: Check one or more Hispanic or Latino Mexican Puerto Rican Cuban Other Hispanic or Latino - print origin For example: Argentinean, Colombian, Dominican, Nicaraguan, Salvadoran, Spaniard, And So On. Not Hispanic or Latino I do not wish to provide this information Race: Check one or more American Indian or Alaska Native - Print name of enrolled or principal tribe: Asian Asian Indian Chinese Filipino Japanese Korean Vietnamese Other Asian - Print race: For example: Hmong, Laotian, Thai, Pakistani, Cambodian, And So On. Black or African American Native Hawaiian or Other Pacific Islander Native Hawaiian Guamanian or Chamorro Samoan Other Pacific Islander - Print race: For example: Fijian, Tongan, And So On. White I do not wish to provide this information Sex Male Female I do not wish to provide this information
