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Pre-Qualify for a Home Mortgage Loan
Application Instructions:
  • Use this short form to Apply On-line.
  • Please fill out as much of this form as possible.
  • When finished click on the send button.
    NOTE: (By submitting the following, you grant us permission to obtain your credit report.)
  • A mortgage specialist will contact you. A phone number is required.

Credit History

Please check appropriate box:

 Excellent  Good  Fair  Poor

General Information

  Borrower Co-borrower

Full Name:

Address:

City, State, Zip

Home Phone:

Work Phone:

Social Security # :

E-mail          :

Loan Request

Amount Requested:

Type of loan:

   Debt Consolidation  Purchase  Refinance

Property Information

Estimated Present Value:

Type of Property:

 Primary Residence  2nd Home  Rental

Current Loan Information

Mortgage Balances Amount: Rate Payment:

First:

Second:

Other:

Current Employment Information

  Borrower Co-borrower
Are you Self Employed? Yes No Yes No
Gross Monthly Income
Time on Current Job: Yrs: Mos: Yrs: Mos:
How did you hear of Us?

Other information and comments:

 
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160 Doyle Road• Holden, Massachusetts 01520 • Phone 888-442-2274• Fax 508-852-4112