FREE Online Loan Prequalification Form
 * Note - This Mini 1003 Form example page is active. Please feel free to try the form with a test submission.

The information provided below is not a formal loan application, but will be used to determine our estimate of the borrower's qualification to obtain a mortgage loan.

Pre-Qualification Information: 
Please use the "TAB" key to move between fields.   DO NOT USE the "ENTER" key.

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                                    Google   Web Crawler  Yahoo  Other search engine
Loan Amount:

Type of Loan:
Purchase Refinance  Second Home Income Property
Type of Financing:
Conventional Fixed  Conventional ARM  FHA  VA

Customer Information

Borrower: 

Co-Borrower:  

E-mail: 

Current Street Address: 

City:    State:    Zip Code: 

Home Phone:    

Work Phone: (include extension if applicable)

Property Information

Purchase Price (Current Value of Property if refinance): 


Cash Down payment: (If Purchase)


Property Address: 

Property City:    

Property State:    Property Zip Code: 

Property Type:
Single Family  Condo/Townhouse  Multi Family

Will you occupy the property?:
Yes  No

If purchasing, do you have a RealtorŪ with whom you are working?
Yes  No

Would you like for us to find a RealtorŪ who specializes in your area?
Yes  No

Credit Information

How would you rate your Credit?  Excellent   Good   Fair   Poor

Borrower Employment Status:                      Co-Borrower Employment Status:
Salaried/Hourly Self Employed        Salaried/Hourly  Self Employed

Borrower Employer:                                       Co-Borrower Employer                     
                            
Number of years with Company:                Number of years with Company:
                                                          
Borrower Gross Monthly Income:             Co-Borrower Gross Monthly Income:
                                                 
Liquid Assets: (Include checking, savings, stocks, mutual funds etc.)
                                                 
Borrower Retirement and 401k:                 Co-Borrower Retirement and 401k:
                                                 
Borrower Monthly Auto Payments:            Co-Borrower Monthly Auto Payments:
                                                 
Borrower Credit Card Minimum Mo. Pmt:  Co-Borrower Credit Card Minimum Mo. Payment:     
                                                 
Other Monthly Debt: (Child Support, Student Loans. Do not include current house payment, rent or utilities)

If Refinancing Answer the following:

If refinancing, enter outstanding balance owed:

What is your Current Interest Rate?:

Type of Current Loan:
 Conventional   FHA  VA   Other
Current Monthly Payment (excluding taxes):

Annual Property Taxes:

Do you currently have Mortgage Insurance?:
Yes No
Do you have a Second Mortgage or a line of credit on the Subject Property?:
Yes No
Do you want to keep this loan or consolidate it with the first mortgage? 
Keep  Consolidate

Any additional information?  Tell us what you'd like to do.  Type in box below:

Thank you  

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