Mortgage Prequalification Form

*First Name:

*Last Name:

*Email Address:

How much would you like to borrow?

Do you have a co-borrower?

Do you prefer a fixed or adjustable rate?

Desired term of loan:

Your employment status:

How long have you had your current position?

Co-borrower's employment status:

How long has the co-borrower had this position?

Do you currently own or rent your home?

Your monthly income:

Your monthly housing cost:

Other monthly expenses and debts:

Phone:

Address:

City:

State:

Zip Code:

Comments: