Prequalification Application

Fields with a background are required. How did you hear about us? Yahoo Google Alta Vista MSN Other Internet E-mail Search Engine Referral TV Ad Direct Mail Pop-Up Other Are you in contact with a Loan Officer? If yes, choose name: "Dave Engel" Bryan J. Smith James Worsham    Loan Information Enter either a sales price and/or a loan amount   Sales Price $   And/Or   Loan Amount $   Down Payment %    and/ or    $    Borrower's Name, Present Address and Contact Information Is there a co-borrower? Yes    No Co-Borrower fields are required only if there is a co-borrower.   Borrower Co-Borrower First name Middle initial Last name Street City State Please select oneAlabama Alaska American Samoa Arizona Arkansas Armed Forces Africa Armed Forces Americas Armed Forces Canada Armed Forces Europe Armed Forces Middle East Armed Forces Pacific California Colorado Connecticut Delaware District Of Columbia Fdr. state_s Of Micronesia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Marshall Islands Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Northern Mariana Islands Ohio Oklahoma Oregon Palau Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming Please select oneAlabama Alaska American Samoa Arizona Arkansas Armed Forces Africa Armed Forces Americas Armed Forces Canada Armed Forces Europe Armed Forces Middle East Armed Forces Pacific California Colorado Connecticut Delaware District Of Columbia Fdr. state_s Of Micronesia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Marshall Islands Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Northern Mariana Islands Ohio Oklahoma Oregon Palau Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming Zip code Years at the address Work phone  e.g. 415-123-4556 Home phone e.g. 415-123-4556 Cell phone e.g. 415-123-4556 Email address     Employment Information Employment status Employed Self-Employed Retired Investor Student Home-maker Other Name of your company Employment address City State Please select oneAlabama Alaska American Samoa Arizona Arkansas Armed Forces Africa Armed Forces Americas Armed Forces Canada Armed Forces Europe Armed Forces Middle East Armed Forces Pacific California Colorado Connecticut Delaware District Of Columbia Fdr. state_s Of Micronesia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Marshall Islands Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Northern Mariana Islands Ohio Oklahoma Oregon Palau Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming Zip code Your title/position Years at the job Years in the profession Your income Other income Co-Borrower's income    Disposition of Current Residence Do you rent? Yes    No      If so, amount per month Do you own a house? Yes    No      If so, mortgage payment      and how long at this address? Do you plan to sell your existing home? Yes    No Value of your home    Credit Information How is your credit history? Excellent Good Somewhat Good Poor Have you ever filed for bankruptcy? Yes    No Borrower's Social Security Number Co-Borrower's Social Security Number We have to take your credit report before we can consider you for pre-approval. Do we have  permission? Please select Yes if you understand and agree to the terms and conditions. Yes    No