Loan Qualification
Date ____________________________ Referring Agent _______________________________
Loan Officer ___________________________________________________________________
Customer Name ________________________________________________________________
Current Address ________________________________________________________________
______________________________________________________________________________
Telephone: Home #_________________________ Work/Cell# __________________________
Currently Own Home: Y/N Mo Pymt______ Currently Rent: Y/N $/Mo________________
If own home: Estimate Home Value ________________________________________________
Balance of Current Mortgage __________________________________________
Purchase Price (of home you intend to buy): __________________________________________
Amount of Down Payment (if any): ________________________________________________
Current Employer: __________________________________________ Phone:______________
Yearly Gross Income:___________________ Time on current job:________________________
Co-borrower’s Employer: ____________________________________ Phone: ______________
Co-borrower’s Gross Income: _____________________Time on current job:________________
Birthdate:__________________________ SSN#______________________________________
Co-borrower’s Birthdate_______________ SSN# _____________________________________
Permission to obtain credit report? Y/N
Additional Comments: (Address of house to purchase; financing interested in; best time to be reached, any other concerns, etc.)_________________________________________________________________
________________________________________________________________________________
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