MLS #

Saturday May 10, 2008

BrokerNetwork

5545 Murray Rd., Suite 320
Memphis, TN 38119

PRE-QUALIFICATION FORM

This is a FREE pre-qualification for a home loan. To apply simply fill out the following form completely and click on the Submit button to send it.

If there is no co-borrower leave all co-borrower fields blank

Borrower

First Name: *

Last Name: *

Address:

City:

State:

Zip:

Phone: (Home)

Phone: (Work)

Email: *

Gross Monthly Income:

Type Of Income:

Co-Borrower

First Name: *

Last Name: *

Address:

City:

State:

Zip:

Phone: (Home)

Phone: (Work)

Email: *

Gross Monthly Income:

Type Of Income:

Current Obligations

Existing Loan Information

(skip if this is a purchase)

Type Of Property:

Balance On Existing Mortgage:

Current Monthly Payment:

Current Interest Rate:

Estimated Value Of Home:

New Loan Information

Loan Amount:

Down Payment If Applicable:

Term:

How would you rate your credit?:

If this is a purchase, have you found your property yet? Yes No

Comments:

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