LOAN APPLICATION

Borrower
Borrower
Primary Phone ext.
Secondary Phone ext.
Email
Home Address
City
State
Zip
Own Or Rent
How Long
SS #
DOB

Borrower Employment History
Self Employed
Employer
Position
Years At Job
Income (per year)
Other Income
Source Of Other

Co-Borrower
Co-Borrower
Primary Phone ext.
SS #
DOB

Co-Borrower Employment History
Co Self Employed
Employer
Position
Years At Job
Income (per year)
Other Income
Source Of Other
Previous Address
Address
City
State
Zip

New Home Information
Property Type
Property Address
Property City
Property Zip
Est Closing Date
Sales Price
Down Payment
Loan Amount

Assets
Retirement Accts, IRA, 401K, Annuties, etc.
Non Retirement Accts, Checking, Savings, Investments ,etc.
This is an application for a mortgage loan pre-qualification. Additional information may be required. By submitting, you authorize to obtain a credit report and verify items necessary to obtain pre-qualifcation.