PRE-QUALIFICATION APPLICATION

*Please fill out the following information completely. Type N/A if not applicable.*

Personal Information

Full Legal Name *

Marital Status *

Age *

Date of Birth *

Social Security Number *

Phone *

Email *

Are You in School? If Yes, How Long? *

Number and age of dependents (if any) *

Alimony/Child Support - Amount Paid or Received (if applicable) *

Current Address *

Own or Rent *

How Long Have You Lived at Current Address? *

Monthly Mortgage/Rental Payment *

Previous Address (if at current address less than 2 years) *

Own or Rent (at previous address) *

How Long (previous address) *

Monthly Mortgage/Rental Payment (previous address) *

Subject Property Information

Pruchase/Refinance Amount *

Amount of Down Payment *

Source of Down Payment *

Annual Real Estate Property Tax *

Address of Property to be Purchased/Refinanced *

Current Interest Rate/Term *

Monthly Condo Fee *

Home Owners Insurance Amount *

2 Year Employment History

Name & Address of Current Employer *

Years on this Job *

Job Title *

Gross Monthly Income *

Years in this Line of Work *

Main Work Phone *

Dates (from-to) *

Name & Address of Previous Employer (if at current employer less than 2 years) *

Main Work Number (previous employer) *

Assets/Bank Accounts

Name & Address of Bank/Institution *

Type of Account *

Account Number *

Balance *

Home Owners Insurance Information

Home Owners Insurance Agent *

Address, & Phone Number *

Owned Real Estate

Property Address *

Investment Property/Second Home/Other? *

Rental Income (if applicable) *

Monthly Mortgage Amount *

Declarations

Are there any outstanding judgements against you? *

Have you been declared bankrupt within the last 7 years? *

Have you had property foreclosed upon or given title deed in lieu thereof in the last 7 years? *

Are you a party to a lawsuit? *

Have you directly or indirectly been obligated on any loan which resulted in foreclosure, transfer of title in lieu of foreclosure, or judgement? *

Are you obligated to pay alimony, child support, or separate maintenance? *

Are you presently delinquent or in default on any Federal debt or any other loan, mortgage, financial obligation, bond, or loan guarantee? *

Is any part of the down payment borrowed? *

Are you a co-maker or endorser on a note? *

Are you a US citizen? *

Are you a permanent resident alien? *

Do you intend to occupy the property as your primary residence? *

Have you had an ownership interest in a property in the last 3 years? *

What type of property did you own- principal residence (PR), second home (SH), or investment property (IP)? *

How did you hold title to the home-solely by yourself (S), jointly with your spouse (SP), or jointly with another person (O)? *

Sign & Date

Full Name *

Signature *

Clear

By providing signature, I attest that the information is true to the best of my knowledge and ability.

Date *

DISCLAIMER: The information provided on these pages is general information only and is not intended as legal advice. LIVE Legal Services Inc. is not staffed by lawyers and does not provide legal advice. We provide legal documents, at your direction, enabling you to represent yourself, Pro Se, in a court of law. We are not lawyers. We cannot represent anyone in a court of law, nor can we give you legal advice. Please consult an attorney for legal advice and remedies. LIVE Legal Services Inc. is located and doing business in the State of Florida ONLY. If you are from any other state, please check your local state laws and consult your local telephone directory for an attorney in your area.