Mortgage Pre-Qualification Application

Getting pre-qualified will help you know approximately how much you can borrow, using financial information that you provide. There's no cost and no commitment!

Loan Information

Are you applying as an individual or with a co-borrower? Individual Co-Borrower

Borrower Information

First Name Middle Initial Last Name Suffix Social Security Number Birth Date Mother's Maiden Name Current Residency Start Date Home Address City State Zip Code Home Phone Number Work Phone Number E-mail Address Please do NOT email me important news and updates.

How would you prefer to be contacted? Home Phone Work Phone Email Other

Other Preference Bank Name

Borrower Employment

Borrower Employment Status Employed Not Employed

Employment Start Date Position / Title Gross Monthly Income Name of Employer Employer's Phone Number

Previous Employer if employed less than 2 years

Employment Start Date Position / Title Gross Monthly Income Name of Employer

Co-Borrower Information

How would you prefer to be contacted? Home Phone Work Phone Email Other

Other Preference Bank Name

Co-Borrower Employment

Borrower Employment Status Employed Not Employed

Employment Start Date Position / Title Gross Monthly Income Name of Employer Employer's Phone Number

Previous Employer if employed less than 2 years

Employment Start Date Position / Title Gross Monthly Income Name of Employer

Property Information

Current Monthly Mortgage Payment/Rent

Will the property be a primary residence or a second/vacation home? Primary Residence 2nd/Vacation Home

Sale Price Mortgage Amount

Agreement/Signature

I certify that all information provided by me is true, correct and complete. I authorize Mauch Chunk Trust Company to make whatever inquiries about me you deem necessary and appropriate for the purposes of evaluating my credit application. Including credit reports and contacting my employer. I also authorize Mauch Chunk Trust Company to provide credit information about its credit experience with me to other creditors and credit reporting agencies.

Borrower's Signature - Please type your first and last name Date I understand that checking this box constitutes a legal signature confirming that I acknowledge and agree to the above Terms of Acceptance.

Co-Borrower's Signature - Please type your first and last name Date I understand that checking this box constitutes a legal signature confirming that I acknowledge and agree to the above Terms of Acceptance.