Applicant
Information:
First
Name & M.I.
Last
Name
Co-Applicant
Name
Street
Address
City
State
--Please select one--
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Zip
Email
Address
Day
Time Phone
Evening
Phone
Best
Time to Call
Loan
Information:
Desired
Loan Amount
I
Currently
-- Please Select --
Own
Rent
-- Please Select --
None
Single Family
Condo
Townhouse
Investment
Apartment
Other
Monthly
Payment
Annual
Income
-- Please Select --
$20,000
$25,000
$30,000
$35,000
$40,000
$45,000
$50,000
$55,000
$60,000
$65,000
$70,000
$75,000
$80,000
$85,000
$90,000
$95,000
$100,000
$110,000
$120,000
$130,000
$140,000
$150,000
$160,000
$170,000
$180,000
$190,000
$200,000
$225,000
$250,000
$275,000
$300,000
$325,000
$350,000
$375,000
$400,000
$425,000
$450,000
$475,000
$500,000
$525,000
$550,000
$575,000
$600,000
$625,000
$650,000
$675,000
$700,000
$725,000
$750,000
My
Credit History Is
-- Please Select --
Excellent
Good
Fair
Poor
Ever
filed for bankruptcy?
-- Please Select --
No
Yes
If
so, when:
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
New
Property Information:
Type
of Property
-- Please Select --
Single Family
Multi Family
Coop/Condo
Commercial
Lot
Other
Estimated
Purchase Price
New
Property City & State
-- Select State --
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Questions
/ Comments
I understand that by submitting this application that I am applying for a loan. This application is being used as a pre-qualification only and is not an application for credit.