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Originator Prequal
Loan Program
Type of Loan:
Purchase
Refinance
Fixed
ARM
Other
Term:
10
15
20
30
TBD
Sales Price (or Market Value if Refi):
Loan Amount:
Property Information
Property Address:
Property City:
Property State:
Property Zip:
Property Type:
SFH
Condo
Townhome
Income
Other
Borrower Information
First Name:
Last Name:
Home Phone:
Work Phone:
E-mail:
Credit History:
Excellent
Good
Fair
Poor
Employment Information
Employer:
Years on Job:
Position:
Current Gross Income:
Yr
Mo
BiWk
Wk
Borrower Assets
Escrow Deposits:
1st
2nd
List all Bank, Brokerage, Retirement, Stock, and Bond Accounts
Name
Account Type
Balance
Co-Borrower Information
First Name:
Last Name:
Social:
DOB:
Address:
City:
State:
Zip:
Day Phone:
Evening Phone:
Previous Address (if less than two years):
Citizenship:
U.S. Citizen
Resident Alien
Other
Co-Borrower Employment
Employer:
Years on Job:
Position:
Current Gross Income:
Yr
Mo
BiWk
Wk
Prev/Other Employer:
Start:
End:
Mo Inc:
Co-Borrower Assets
Borrower Assets
Escrow Deposits:
1st
2nd
List all Bank, Brokerage, Retirement, Stock, and Bond Accounts
Name
Account Type
Balance
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