Express Pre-Qualification Form
HOME
 Who is your Mortgage Planner?
 Who referred you to us?
Step 1. Tell us about you.

 Borrower Information

 What is the Borrower's Name?
(Exactly as it appears on your driver's license)
 First
 Middle Initial
 Last
 Suffix
 What is the Borrower's Current Address?
 Street
 City
 State  
 Zip
 Do you rent or own?
How long (years)
 If less than 2 years, please fill out information about your previous residence.
 Street
 City
 State  
 Zip
 What is your Social Security number and DOB?
 SSN#
 Date of Birth
(use: mm/dd/yyyy)
 What are your telephone numbers?
 Home
 Work
 Cell
 Fax
 What is your Preferred Communication?

 Co-Borrower Information (If any)

 What is the Co-Borrower's Name?
(Exactly as it appears on your driver's license)
 First
 Middle Initial
 Last
 Suffix
 What is the Co-Borrower's Current Address (if different)?
 Street
 City
 State  
 Zip
 Do you rent or own?
How long (years)
 If less than 2 years, please fill out information about your previous residence.
 Street
 City
 State  
 Zip
 What is your Social Security number and DOB?
 SSN#
 Date of Birth
(use: mm/dd/yyyy)
 What are your telephone numbers?
 Home
 Work
 Cell
 Fax
 What is your Preferred Communication?
  Who should my team and I consider as the primary contact throughout the loan process?
Step 2. Tell us about your situation.
 What is the purpose of this loan?
 If you selected "Refinance" or "Equity Repositioning", what is the type?
 What type of mortgage loan are you interested in?
 What type of Loan Program are you interested in?
 What is the length of your requested loan in months?
 If you selected "Other", please explain.
 What is the property address (if available)? [Leave blank if Equity Reposition or Refinance.]
 Street:
 City:
 State:
 Zip:

 Occupancy type:    

 


 What is the desired loan amount (if repositioning equity or refinancing)? $
 If purchase, what is the estimated or desired purchase price? $
 If purchase, what is the estimated down payment amount? $ or %
 If purchase, where will the down payment come from?
 If equity reposition or refinance, what is the total owed on home?
Step 3. Tell us about your employment.
(need two year history)

 Borrower

 Self Employed?   Yes    No
 Employer:
 Position Title:
 How Long (Yrs/Mths):   /
 Years in this line of work:
 If less than two years, add previous:
Employer
Position Title
 How Long (Yrs/Mths):   /

 Co-Borrower

 Self Employed?   Yes    No
 Employer:
 Position Title:
 How Long (Yrs/Mths):   /
 Years in this line of work:
 If less than two years, add previous:
Employer
Position Title
 How Long (Yrs/Mths):   /
 
 
Gross Monthly Income
(please separate Borrower and Co-Borrower)
Borrower Co-Borrower
Base Empl Income $ $
Overtime $ $
Bonuses $ $
Commissions $ $
Dividends/Interest $ $
Net Rental Income $ $
$ $
$ $
Step 4. Tell us about your assets.
 Borrower Assets
Amount Source Institution
 Do you claim any unreimbursed business expenses on your tax return?   Yes    No
 Are you obligated to pay alimony and/or child support?   Yes    No
Other Information
 Which best describes your situation? (feel free to use both drop downs)
 How would you rate your credit? (Rate 1 to 5, "1" being most challenging, "5" being excellent).  
Are all borrowers US Citizens?
Is either borrower self-employed, own 25% or more of a corporation, or derive 25% or more of income from commissions?
  I am working with a real estate agent.
  Yes    No

 
Agents Name:
Company:
Phone Number:  
 Additional Comments:

 * I/We (borrower[s] named herein) understand that this form is for pre-qualification only and is not a full loan application.

Authorization to check credit verification
YES    NO
I certify by selecting "Yes", I/we have the authority and consent of all applicants to authorize lender to obtain such information.
 

 Email Address:

 

 
Optional Information for Mortgage Planning:
This section is optional and does not affect your loan pre-qualification. The purpose of this section is to help us to better understand your specific needs & goals as they relate to your overall long & short - term financial goals.

"Most people spend more time researching the VCR or DVD player they plan to buy that they do making sure the mortgage they select is right for their specific financial needs. A DVD player costs between $100-$300 but many homeowners pay $10,000-$50,000 per year on their mortgage payments. Make sure you work with a mortgage planner who takes the time to structure your mortgage loan so that it works well with your overall financial strategy." - Barry Habib, CNBC

1.  What is the best estimate for how long you might live in this home?

2.  Over the next 5 years, will your household income:

3.  On a scale of 1-10, how would you assess your tolerance to financial/investment risk (1 being most conservative, 10 being most aggressive)

4.  Do you plan on making additional principal reduction payments in addition to your scheduled monthly mortgage payments?

5.  Of the following financial goals, which would you say is a top priority currently?
    Improve Monthly Cash Flow
    Create a 6-12 Month Reserve Account
    Maximize Retirement Savings
    Maximize Education Savings
    Live Comfortably on One Income
    Maximize Asset Portfolio Performance
    Live Comfortably on a Fixed Income
    Create a Comprehensive Financial Plan

6.  Which of the following is most important regarding your mortgage financing? (check all that apply)
    Minimize Monthly Payments
    Maximize Equity Accumulation (early payoff)
    Obtain cash to pay off debt, or make home improvements
    Maximize tax benefits
    Eliminate mortage insurance
    Minimize cash due at closing


7.  On a scale of 1-10 (10 Being highest) how would you rate your satisfaction with the following?
1. Realtor
2.CPA
3.Financial Planner
4. Insurance Agent
 Realtor-Buyer's

Name:

Company:
Phone Number:
- -

 Insurance Agent
Name:
Company:
Phone Number:
- -
Annual Hazard Ins. Premium(Fire):

 Tax Consultant-Accountant

Name:

Firm:
Phone Number:
- -

 Stock Broker-Fin. Planner
Name:
Firm:
Phone Number:
- -

 
MortgageBanc
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2007 Eagle Ridge Drive
Birmingham, AL 35242

Phone: (205) 986-4220
Fax: (205) 986-4221

contact us


NMLS# 2289

Equal Housing Lender

(c)2009 Tandem Training & Consulting™