We are pleased to offer you the opportunity for a FREE mortgage needs pre-qualification. Please complete the following information and submit it to us. We will submit your private loan application securely to our preferred lender & they will be contacting you directly. If you have any questions, please do not hesitate to call. Remember, at Prudential, Service is our Number 1 Objective!

TODAY'S DATE:

PERSONAL DATA:
Borrower Name: (inc. middle initial)
Co-Borrower: (inc. middle initial)
Current Address:
City:
State:
Zip:
How Long:

    Own    Rent

If less than 2 years at current residence, please provide 2 year history with all information on previous residences, along with dates:
Borrower SS#:
Co-Borrower SS#:
Borrower DOB:
Co-Borrower DOB:
# Dependants: Age(s):
Borrower Wk. Phone:
Co-Borrower Wk. Phone:
Home Phone:

EMPLOYMENT HISTORY:
Borrower Present Employer:
Address:
Position:
How Long:
Gross Income: $ per week month year
Co-Borrower Employer:
Address:
Position:
How Long:
Gross Income: $ per week month year
If less than 2 years on current employment, please provide 2 year history on previous employers including dates of employment, etc., with complete address(es) and phone number(s):

ASSETS:
(include checking, savings, money market accounts, etc., on accounts that will be used for down payment)
Bank:
Average Balance: $
Bank:
Average Balance: $
Bank:
Average Balance: $

MORTGAGE INFORMATION:
(If applicable)
Current Mortgage Holder:
Phone #:
Address:
Balance (if applicable): $
Est. Value of Your Home: $
Purpose of Loan: Purchase     Refinance
Loan Term: 15 year   20 year   30 year
Loan Type: Conventional  FHA

I/We have made a pre-approval request for maximum loan amount information. I/We understand that I/we have not identified any specific property to the lender, nor have I/we made a written application for a loan with the lender. Any information provided by the lender regarding loan amount is subject to the property I/we select appraising in excess of the minimum value required for the loan program I/we select. Such information is also subject to verification of all data I/we will be required to provide on a written application. I/We the consumer, direct the preferred lender to obtain a copy of my credit report. The consent shall automatically expire thirty (30) days from the date typed above.

Realtor:

Home Mortgage Consultant:
Mary Hamilton
Fidelity Bank
316.291.5623
316.990.0671 cell
316.291.5629 fax

 

[Plaza Real Estate]
3531 N. Ridge Rd.
Wichita, KS 67205

Greg Yocom
RealtorŪ, ABR, GRI

Phone: 316-721-9271
or 316-806-1188

[e-mail]
E-Mail Me


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