Mortgage Pre-Qualification Application

Applicant 1

I am:

Current Address

I Currently:

Current Employer


If Under 2 Yrs., List Previous Employer

Applicant 2

I am:

Current Address

I Currently:

Current Employer


If Under 2 Yrs., List Previous Employer


Gross Monthly Income by Applicant

*Alimony, child support, or separate maintenance income need not be revealed if Applicant 1 or Applicant 2 does not choose to have it considered for repaying this loan.

Applicant 1

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$
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$
$
$
$

Applicant 2

$
$
$
$
$
$
$

Combined Applicant Information for Debts

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$
$
$
$
$
$
$
$
$
$

If you own a home, will it be sold?:

I will make a down payment on the Purchase Price of:

I authorize release of my Approval Certificate to:



Declarations

Applicant 1

Are you a co-signer or co-maker on a loan?:
Are there any outstanding judgments against you?:
Have you been declared bankrupt in the past seven years?:
Have you had a foreclosure/given deed in lieu in the last seven years?:
Are you a party to a lawsuit?:
Is any part of the down payment borrowed?:
Are you a U.S. Citizen?:
Will the proposed property be your:

Applicant 2

Are you a co-signer or co-maker on a loan?:
Are there any outstanding judgments against you?:
Have you been declared bankrupt in the past seven years?:
Have you had a foreclosure/given deed in lieu in the last seven years?:
Are you party to a lawsuit?:
Is any part of the down payment borrowed?:
Are you a U.S. Citizen?:
Will the proposed property be your:


INFORMATION FOR GOVERNMENT MONITORING PURPOSES: The following information is requested by the federal government for certain types of loans related to a dwelling in order to monitor the lender's compliance with equal credit opportunity, fair housing and home mortgage disclosure laws. You are not required to furnish this information but are encouraged to do so. You may select one or more designations for "Race." The law provides that a lender may neither discriminate on the basis of this information, nor on whether you choose to furnish it. However, if you choose not to furnish the information and you have made this application in person, under federal regulations the lender is required to note ethnicity, race and sex on the basis of visual observation or surname. If you do not wish to furnish the information, please check below.

Applicant 1

Ethnicity:

Race:




Sex:

Applicant 2

Ethnicity:

Race:




Sex:

IMPORTANT INFORMATION ABOUT PROCEDURES FOR OPENING A NEW ACCOUNT: To help the government fight the funding of terrorism and money laundering activities, Federal law requires all financial institutions to obtain, verify, and record information that identifies each person who opens, an account. What this means for you: when you open an account, we will ask you for your name, address, date of birth, social security number, and other information that will allow us to identify you. We will also ask to see your driver's license or other identifying documents.

CERTIFICATION: I/We, the undersigned, certify that the information provided is true and correct as of the date of my/our signature(s) and acknowledge that any intentional misrepresentation may be at the Lender's sole discretion void this application and all commitments made in conjunction therewith by the Lender. I/We acknowledge and agree that verification or re-verification of any information provided by me/us may be made at any time by the Lender, its agents, successors, and assigns (either directly or indirectly through a credit reporting agency or from any source stated above).