Request For Free Pre-Qualification Form
Borrower First Name:
M.I.:
Last Name:
Co-Borrower First Name:
M.I.:
Last Name:
Street Address:
Apartment #:
City:
State:
Zip:
Email:
Home Phone:
Work Phone:
Fax:
Cell Phone:
Best Time To Call:
Children:
Yes
No Number of Children:
Borrower Annual Income Before Taxes:
$
Co-Borrower Annual Income Before Taxes: $
Monthly Debt (
Please include monthly payments of all that apply
):
Auto Payment:
$
Credit Cards:
$
Student Loans:
$
Housing:
$
Rent or own:
Rent
Own
Other:
$
Cash For Down Payment:
$
Borrower SS # :
Co-Borrower SS #:
I think my credit is:
Ok
Excellent
Good
Credit Concerns
Poor
Declared bankruptcy:
Yes
No
If yes date of discharge:
Reason for bankruptcy:
Select One
Medical Reasons
Business Failure
Divorce
Other
If other explain:
Authorization to check credit:
Yes
No
Are you VA eligible:
Yes
No
Do you have an agent:
Yes
No
If yes, what is agents name:
Agents Phone:
When do you want to move:
1-2 Months
3-6 Months
Beyond 6 Months
As Soon As Possible
Preferred State:
Choose A State
Maryland
Washington D.C.
Virginia
Other
Preferred Counties/Cities/Towns:
Will you be applying for down payment assistance:
Yes
No
Not Sure
Select One
How did you hear about us:
Select One
Search Engine
Washington Post
Gazette
Mailing
Friend/Relative
Realtor
Other
If other please explain:
Special requirements/needs:
If you
have authorized a credit check, an in-file credit report will be run free of
charge.
Your completed form will be submitted to a recommended lender for pre-qualification.