Web
Form
Pre-Qualification Application
Borrower's Name
Address
Home Number
Cell Phone Number
Best Time to Call
E-mail Address
Marital Status
Married
Single
Divorced
Widowed
Social Security Number (SSN)
Date of Birth
How's your credit?
Excellent 726 - 830
Very Good 700 - 725
Good 626 - 699
Ok 551 - 625
Poor 330 - 550
Don't know
Ok to Pull Credit Report?
Yes
No
Please contact me prior to pulling credit.
Any bankruptcies or liens?
Yes
No
Loan Purpose
Purchase
Refinance
Estimated Value of Home
Balance Remaining on Existing Loan
Current Monthly Payment
Employment Status
Self-Employed
Full-time Employee
Part-time Employee
Total Household Income
$25,000-$30,000 per year
$31,000-$40,000 per year
$41,000-$50,000 per year
$51,000-$65,000 per year
$66,000 and above per year
How did you hear about us?
Comments or Questions
Web
Form
Service Provided by
Doteasy Web Hosting
for
CROSSTOWNMORTGAGEGROUP.COM
