Request for Pre-Qualification - City Town Info

Request for Pre-Qualification

This is not an application for a mortgage loan. The information provided is to be used to determine

the likelihood that the named borrowers will be able to obtain a mortgage loan. All information is

subject to verification at the time of application for a mortgage loan.

General Information

Purchasing (check one)

Amount for Down Payment

First time home buyer?

Yes

Single Family

Condo

Multi-Family

$

No

Borrower Information

Borrower

Name:

Social Security Number:

Date of Birth:

Present Address (street, city, state, ZIP)

Co-Borrower

Name:

Social Security Number:

Date of Birth:

Present Address (street, city, state, ZIP)

Home Phone

Work Phone

E-Mail

Name of Employer

Title/Position

Years at Employer

Home Phone

Work Phone

E-Mail

Name of Employer

Title/Position

Years at Employer

(

(

)

)

(

(

)

)

Income Information

Do you have income documentation?

Base Salary

$

Overtime

Bonuses

Commissions

Other

Total

$

Yes

No

Base Salary

Overtime

Bonuses

Commissions

Other

Total

$

$

Asset/Liability Information

Checking/Savings

Investment

Retirement

Other (describe)

Assets

Amount

$

Liabilities

Monthly Payment

$

Home Loan

Credit Card Debt

Auto Loan

Other Loans (student

loans, equity lines etc.)

Total

$

Total

$

I hereby authorize Sample Mortgage Corporation to order a consumer credit report. The information

Sample Mortgage Corporation obtains is only to be used for mortgage pre-qualification purposes and

potential subsequent processing of my application for a mortgage loan.

Borrower Signature

Date

Co-Borrower Signature

Date

 ................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download