Pre-Qualification Worksheet

Date ...

Time: ..

Who Referred To Us : ...

Borrower Information:
Email Address: ..
Name: (first,middle,last) ...
Date of Birth: (mm/dd/yyyy) .. Soc. Sec# .
Cell Phone: ... Home Phone: ....
Employer/ Rank & Years of Service: ETS Date: ....
Monthly Income: ... Disability: ..... Retirement: . Other: ...
Current Address: ................................................. City: State & Zip ..
Rent / Own (circle) Payment:.

How many years: ..

First Time Purchase: yes/ no

If owned what do you plan to do with the property: ........

How many children: . Ages: ..

Is this a VA: yes/no (circle)

Do you pay childcare/support? If so how much? ....

Any Advance Pay?

..
Co-Borrower Information:
Email Address:..
Name: (first,middle,last)
Date of Birth: (mm/dd/yyyy) .. Soc. Sec# .....
Cell Phone: ....

Home Phone: ...

Employer/ Rank & Years of Service: .. ETS Date: ..

Monthly Income: ... Disability: . Retirement: . Other: ....
Current Address: .... City: .. State & Zip ...
How many children: Ages: ......

Do you pay childcare/support? If so how much? ....