Loan Prequalification Form

Purchasing a Home?

Instructions: Use this form if you are interested in prequalifying for a loan to learn how large a loan you could get. You can submit your application in any of the following ways.

Submit this application electronically by clicking on the "Send Information" button (this form is not secure, so please do not include any account numbers).
Print and mail this application to: , , , , .

I will contact you if additional information is needed to obtain your prequalification. If you have any questions, please contact me at .

Personal Information

Name:

Home Phone Number:

Work Phone Number:

Fax Number

E-mail Address:

Best time to call: am pm

Preferred to be contacted by:

Street Address:

City:

State:

Zip:

Property Information (if applicable)

Street Address:

City:

State:

Zip:

Property type:

If other, please specify:

Occupancy type:

If other, please specify:

Loan Information

Loan Amount

Purpose of loan:

If other, please specify:

Down Payment

Income:
month year

Monthly housing expense:
(mortgage, rent, insurance, etc.)

Monthly Credit Card Payments:

Monthly Loan Payments:

Other Monthly Expenses:
(auto, student loan, alimony, etc.)

Credit History:

Bankruptcy/Foreclosure:

Other Information:

Comments:

Personal Information
Name:
Home Phone Number:
Work Phone Number:
Fax Number
E-mail Address:
Best time to call:	am pm
Preferred to be contacted by:
Street Address:
City:
State:
Zip:
Property Information	(if applicable)
Street Address:
City:
State:
Zip:
Property type:
If other, please specify:
Occupancy type:
If other, please specify:
Loan Information
Loan Amount
Purpose of loan:
If other, please specify:
Down Payment
Income:	month year
Monthly housing expense:	(mortgage, rent, insurance, etc.)
Monthly Credit Card Payments:
Monthly Loan Payments:
Other Monthly Expenses:	(auto, student loan, alimony, etc.)
Credit History:
Bankruptcy/Foreclosure:
Other Information:
Comments: