To be Pre-Qualified for a mortgage, please provide me with the following requested information. Please fill in as much information as possible, if you don't know something you may leave it blank. Depress the submit button when done and I will have an answer for as soon as possible, this form only takes a few minutes. There is no charge for this service. 
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Purpose of Loan  Select One Purchase Refinance Other  (Required)

Property Use       Select One Owner Occupied Investment 2nd Home Other  (Required)

Number of Units Select One 1 Single Family 2-4 units Dup/Tri/Four 5-10 Units Commercial 10+ Units Commercial ( 1 for single family) (2-4 for duplex, triplex) etc.
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Subject Property Information :

  ( If you have already a property in mind, enter property info. here, then continue the form.)
Street Address  Unit #
Property City        South Florida Only 
Selling Price of property $
Is the property Listed by a Realtor ? Yes    No    Enter ML# if listed   
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Continue form...." The more information you give us the better we may serve you."

Estimate price value of property in search of $  

Loan amount required $   Number of Years 30 15 10 Loan Type FHA Conventional VA other

Interest rate desired %    Fixed     Adjustable     No down payment loan ?

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Please complete the following information on the borrower/s.

                                                    Borrower                                 Co-Borrower

First Name                                               ( Required )

Last Name                                               ( Required )

Social Security Number (no dash)            ( Required )

Home Phone with area code                    (If same don't enter)

Business Phone with area code               

E-mail address                           ( Required )

Present Address                           ( Required )    Apt #

City                                                 Zip  ( Required )

Do you rent or own                     Rent Own    Number of Years         Rent payment $

Current employment                    years                         years co-borrower

Years same line of work              years                         years co-borrower

Are you self employed ?              no yes                                   no yes

Total monthly payment / debts ( for both )      $ estimate (no utilities or rent )

Total moneys available  for closing cost, down payment, etc.     $ (if using 401k include)

Income Information :

Gross monthly income for                   
(only enter what is applicable)                         Borrower                                     Co-Borrower

1. Base employment income                              

2. Overtime                                                       

3. Bonuses                                                        

4. Commissions                                                 

5. Dividends / Interest                                        

6. Net Rental Income                                         

7. Other (Alimony, child support)                       

Please add any additional comments below.

This is not a loan commitment. This form is not a loan application. It's for the purpose of assisting the loan office to determine what loan types, maximum loan amount and are available to the borrowers based on the information supplied and review of an in file credit report.