PreQualification Form
*First Name:
*Last Name:
*Email:
Street Name:
Apt / Suite:
City:
State:		Zip/Postal Code:
Phone:
Property Location:		Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New York New Jersey New Mexico North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
Property Type:		Single Family House Condominium Duplex Multiple Unit Apartment Bldg Office Building Other
Household Income
Gross Paycheck:
Paycheck Frequency:		Weekly Every Other Week Twice a Month Monthly Yearly
Other regular source of income (pensions, disability, alimony, child support), monthly:
Can you document your income through Paystubs, W2s, etc.?:		Yes No
Have you been employed in the same line of work for over 2 years?:		Yes No
Monthly Payments
Car:
Student Loan:
Credit Cards (exclude payoff amounts):
Other:
How would you rate your credit?		Excellent Good Fair Bad I Don't Know
Do you have any of the following Assets?
Checking or Savings Account:		Yes No
IRAs, Keooghs and/or 401K:		Yes No
Stocks and Bonds:		Yes No
Another type of Savings:		Yes No