Mortgage Pre-Qualification Form - Member Home Loan

9601 Jones Rd., Ste. #108 Houston. TX 77065 Office - 832.912.2151 Fax - 832.912.2176

Loan Officer Name: Loan Officer NMLS#:

NMLS# 105693

Mortgage Pre-Qualification Form

Complete the following information and e-mail or fax today! Today's Date

Credit Union Name

Referring Employee Name

Applicant Name

D.O.B.

/

/

SS#

Co-Applicant Name

D.O.B.

/

/

SS#

Current Address

City

Zip

Home Phone

Work Phone

Cell Phone

E-mail

Refinance (rate and/or term change)

or

Cash-Out Refinance

Value $

Balances $

Taxes & Ins. $

P & I $

Current Rate & Term Purchase

Price $

Applicant

Employer

Expected Purchase Date

Down Payment

Co-Applicant

Employer

# of yrs.

Position

# of yrs.

Position

Address

Address

City

Zip

City

Zip

Dates of Employment

Dates of Employment

Income per month

Income per month

Do you give Member Home Loan permission to share your information with its affiliates? Yes

No

Borrower Signature Authorization: I hereby authorize the Lender/Broker to order a consumer credit report and verify other credit information, including past and present mortgage and landlord references. It is understood that a copy of this form will also serve as authorization. This pre-qualification does not constitute a loan approval. Additional information will be required to extend a loan offer.

Borrower:

Date:

Co-Borrower:

Date:

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