Mortgage / Home Equity Pre-Qualification Request


* Required Information


By checking the box you intend to apply for joint credit Yes No

Borrower Information

Name: *
Address: *
City: *
State: *    Zip: *
How long at that address?*
Phone #: *
Social Security #: *
Date of Birth: *
Current Employer:
(If less than 2 years enter previous employer)
Previous Employer:
Years at that job:
Gross Monthly Income: *
Work Phone:
Bank Name:
Email Address:

Co-Borrower Information

Name:
Address:
City:
State:    Zip:
How long at that address?
Phone #:
Social Security #:
Date of Birth:
Current Employer:
(If less than 2 years enter previous employer)
Previous Employer:
Years at that job:
Gross Monthly Income:
Work Phone:
Bank Name:
Email Address:
 
Estimated Home Price:
Amount available for down payment:
Preferred Loan Officer:
Other products & services you might be interested in:
  • Checking Account
  • Commercial or AG Loan
  • Consumer Loan
  • Mobile Banking
  • Auto Bill Pay
Who can we thank for referring you?
How do you prefer to communicate?
  • In Person
  • Cell Phone
  • Work Phone
  • Email
  • Text
 

Certification

I/we certify that all information contained above and in exhibits submitted to the lender are true and complete to the best knowledge and belief of the applicant(s) and are submitted for the purpose of pre-qualification for a mortgage loan. I/we understand that you will retain this pre-qualification whether or not it is approved. You are approved to check my /our credit and employment plus answer any questions regarding my/our credit experience with you. This is not a formal application for credit, this is to determine eligibility for certain types of loan products.