PRE-QUALIFY

Fields marked with an asterisk(*) are required. Others are optional.
1. First Name     Last Name 
2. Email Address  
3. Phone Number  
4. * Household Employment Income:
  Gross Paycheck: $  
  Self Employment Income (if applicable):
  2005 Profit from Schedule C (line 29): $
  2005 Depreciation from Schedule C (line 13): $
  2004 Profit from Schedule C (line 29): $
  2004 Depreciation from Schedule C (line 13): $
5. Other regular source of income (pensions, disability, alimony, child support), monthly:
  Notice: Alimony, child support or separate maintenance income need not be revealed if the Borrower (B) or Co-Borrower (C) does not choose to have it considered for repaying of this loan. $
6. Can you document your income through Paystubs, W2s, etc.?
Yes No
7. Have you been steadily employed in the same line of work for over two years?
Yes No
8.  Please list monthly payments on the following:
  8a. Car: $
  8b. Student Loan: $
  8c. Credit Cards (exclude amount that you pay off): $
  8d. Other: $
9.  How would you rate your credit? Excellent Good Fair Poor Don't know
10.  How much will you have in the following types of accounts:
Please note that the following accounts are used to calculate your purchase power.
  7a.* Checking and Savings Accounts: $
  7b. IRA's, Keogh's, and 401K's:
Retirement accounts are calculated at 50% of face value		 $
  7c. Stocks and Bonds NOT INCLUDED ABOVE: $
  7d. Other: $
11. * Property Location: 
12. * Your Property Type:   
Thank you for completing this Pre-Qualify Request!
Click below to send to Dick Blevins.