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Mortgage Loan Pre-Qualification Form
If you wish to be pre-qualified for a mortgage, please provide the information requested
for the borrower and co-borrower (if any). When you are done please click on the submit
button. If you do not have the information to complete a particular part of this application
you may leave it blank.
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Subject
Property Information
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Street
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City
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State
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Zip
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Property value $
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Number of Units
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Year Built
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Property will be
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Loan
Information
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Purpose of Loan
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Loan Amount $
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Number of Years
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Loan Type
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Interest Rate Expected
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Contact
Information
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Borrower
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Co-borrower
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First Name, Middle Initial
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Last Name
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Social Security Number
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Home Phone
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Daytime Phone
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E-mail address
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Address
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City
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State
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Zip
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Rent or Own?
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How Many Years?
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Employment
Information
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Borrower
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Co-borrower
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Years employed at current job
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Years employed in current line of work/profession
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Are you self employed?
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Manager/Supervisor
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Company Name
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Address
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City
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State
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Zip
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Area Code & Phone Number
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Monthly
Financial Information
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Borrower
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Co-borrower
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Base Employment Income*
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Overtime Income
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Bonus Income
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Commission Income
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Dividends/Interest Income
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Net Rental Income
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Other Income**
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Estimated Total Monthly Payments on debts
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Funds available for down payment, closings costs and reserves*
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Feedback
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How did you find this Web site?
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Comments or Questions
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By clicking the "Submit Loan Information Request" button below, you authorize Mortgage
Central. to share the information on this form with a third party for purposes of
loan pre-qualification, and to contact you regarding your pre-qualification status.
Mortgage Central. does not share your personal information with third
party advertisers. Please review our Privacy
Statement if you are unsure about how we use the information collected on this
form.
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*Self Employed Borrower(s) may be required to provide additional documentation such
as tax returns and financial statements.
**Notice: Alimony, child support, or separate maintenance income need not be revealed
if the Borrower(B) or Co-Borrower(C) does not choose to have it considered for repaying
this loan.
© Copyright 2003, Mortgage Central. All rights reserved.
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