Prequalification Form

To speed up the prequalification process, please fill out every field that applies to you.

CONTACT INFORMATION
First Name:
Last Name:
Street:
City / State / Zip:	/ /
Date of Birth:	/ /   (MM / DD / YYYY)
Email:
Home:	- -   (xxx xxx xxxx)
Work:	- -   (xxx xxx xxxx)
Cell:	- -   (xxx xxx xxxx)
INCOME INFORMATION
Borrower Monthly Gross Income:	$  (xxxx.xx)
Years Employed:	$
Co Borrower Monthly Gross Income:	$  (xxxx.xx)
Co Borrower Years Employed:	$
Rental Income:	$  (xxxx.xx)
Other Income:	$  (xxxx.xx)
Monthly Credit Card Debt:	$  (xxxx.xx)
Monthly Car Payment:	$  (xxxx.xx)
Current Mortgage or Rent Payment:	$  (xxxx.xx)
Credit Issues:	$
Can we verify income:	$ Yes   No
ASSET INFORMATION
Bank:	$  (xxxxx.xx)
Money Market:	$  (xxxxx.xx)
Brokerage:	$  (xxxxx.xx)
IRA or 401K:	$  (xxxxx.xx)
Credit Score:	$
Can we verify assets:	$ Yes   No