Exclusive Home Mortgage, Inc.


Pre-Qualification Form

There is no-cost or obligation when submitting this information. If you prefer, you may fax a copy of this form to 205-880-1799.,,, A loan officer will get in touch with you within 48 hours. Thank you.

Personal Information

Name:  
Address:  
Apt#:  
City:  
State:  
Zip:  
Home phone:  
Work phone:  
E-mail Address:  
Marital Status   Single Married Other
Spouse/Co-borrower's name:  
Number Dependants:  

 

Purpose of Loan

Purchase   Refinance  
Relocating Cash out
Staying in same area Rate/term
    Consolidation
    Other

 

EMPLOYMENT INFORMATION

Name of Employer:  
Phone:  
Title:  
Length of time employed
in this position:		  
Length of time
in this profession: 		 
Present monthly salary (before taxes):  
Spouse/Co-borrower's employer:  
Phone:  
Title:  
Length of time employed
in this profession: 		 
Length of time
in this profession: 		 
Present monthly salary (before taxes):  


What is the best place for a
Loan Officer to contact you?:		  

Home
Work
What is the best time for a
Loan Officer to contact you?:		  

a.m.
p.m.


FINANCIAL INFORMATION
(For you and your spouse/co-borrower)


Cash for down payment:     
Real Estate Owned:
Other Assets
(specify)		  
Mortgages   Lender..................................Balance..........Monthly Payment
Auto Loans   Lender..................................Balance..........Monthly Payment
Credit Cards   Lender..................................Balance..........Monthly Payment
Student Loans  

Lender..................................Balance...........Monthly Payment
Other Loans   Lender..................................Balance...........Monthly Payment
Child Support And
other obligations		  
Additional information
that may assist us in
determining your
particular loan needs.		  

Thank you for filling out this form. Press 'submit now' to send form.



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