Preapplication Form                                                                                                                                    Date_____________

Borrower's name_________________________________________Co-borrower's name____________________________

Street Address________________________________________________________________________________________

City_____________________________________________________State_____________Zipe Code________________

Home Phone#______________________Work Phone#_________________________Cell Phone#___________________

What year did you purchase your home?_____________________Purchase price__________________________________

What year did you refinance_________________________Value___________________________

Who is your mortgage with  1st.___________________________________________2nd___________________________

Interest rate____________________Amt of years_________________

How much is your payment per month______________________Balance you now owe__________________________

R.E. Taxes per year_____________________Home owners insurance per year________________________________

Second Mtg with____________________________________Int. rate____________Yrs._____________________

Monthly payment_______________________Balance________________________

For whom do you work?__________________________________________________How long?_______________

What is your position /title__________________________________Monthly income___________________________

Co-borrower's work place________________________________________________How long______________________

Co-borrowers income per month_________________________________

How is your credit____________________________Have you declared bankrupcy___________When___________

When i sthe best time for a loan officer to call__________AM______________PM

All other monthly payments_____________________________