NMLS Mortgage License # 267143
First Name*
Middle Name
Last Name*
Address*
City*
State*
Zip*
Phone*
Email*
Birthdate*
Social Security #*
Gender*---MaleFemale
Marital Status*---SingleMarried
Current Employer*
Time On Job
Income* $ (Gross) Per Month
Other Income $ Per Month
Source Of Other Income
Are You a U.S. Citizen? YesNo
Are You Permanent Resident Alien? YesNo
Bankruptcy in Last 10 Years? YesNo
Do you have any Judgments, Repossessions, Liens, Child Support? Describe:
First Name
Last Name
Address
City
State
Zip
Phone
Email
Birthdate
Social Security #
Gender---MaleFemale
Marital Status---SingleMarried
Current Employer
Income $ (Gross) Per Month
Agent Name
Location of Property
Park
Purchase Price$
How much do you have available for a down payment?*$
Applicant Signature*
Date*
Co-Applicant Signature
Date
PLEASE NOTE: This pre-qualification form is to give the applicant(s) an educated idea on whether they can qualify for a loan or how much they might qualify for. It is no way a loan approval or commitment for a loan. By submitting this information via the website, email, phone, or in person, you are authorizing NW HomeBuyers to pull a copy of your credit report from a major credit bureau in order to determine eligibility. To get an actual loan commitment, the applicant(s) must fill out a full credit application and submit it to our Loan Originator along with a copy of the Purchase Agreement of the home they wish to purchase.