Please provide the following general contact information. All information is held strictly confidential.

First Name
Last Name
Middle Initial
Address
Address (cont.)
City
State/Province
Zip Code
Work Phone
Home Phone
Mobile
E-mail

General Loan Pre-Qualification Information

Please complete as many of the following general financing questions as possible:

Type of home loan you are considering?

Please choose Purchase Refinance 2nd Mortgage Equity Line Other

Intended use of loan?

Please choose Primary residence Vacation home Investment Rental

Property type you are considering?

Please choose Single Family Home Condominium Town House Other

Estimated purchase price of home or property?

Estimated Down Payment?

Will you be selling a property or home first?

Please choose Yes No Maybe

Current Employment? Including number of years at current position

Approximate gross monthly income of borrower?

General credit history of borrower?

Please choose Excellent Good Some credit issues Major credit issues

How soon are you planning to move forward?

Please choose ASAP Next 30 days Next 60 days Next 3 months Next 3 to 6 months Next 6 months Next 6 to 12 months Next 12 months or more

Comments or questions?

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All information is held strictly confidential