Intend to occupy as primary residence?
Yes No Name:
Address:
PLEASE FAX COMPLETED APP TO (888) 285-5307
Pre-Qualification Application:
Sales Price: $
Down Payment: $
Employer: DOB: (mm/dd/yyyy)
Self Employed
B u ye r Inf or mat ion
Address: Phone Number: CIty Previous Address: (If less than 2 years at current) US CItizen Yes No Permanent Resident Yes No Married Separated Single/Divorced Separated Foreclosure in the last 5 years? Home Number: State: Zip:
E m pl oy m e n t In f o r m at i o n
SSN:
Occupation/ Title: Address: Work Number: City: Monthly Gross Base Income: State: Zip
Monthly OT/Bonus/Commission
Start Date: (mm/dd/yyyy) Previous Employer: (If less than 2 years at current)
Years in this line of work: 1-2 3-6 7-10 11> Length of Employment Occupation/ Title:
Bankruptcy in the last 7 years?
Rent
Own
Monthly Payment:
Phone:
Name: DOB: (mm/dd/yyyy)
Employer:
Address: Phone Number: CIty Previous Address: (If less than 2 years at current) US CItizen Yes No Permanent Resident Yes No Married Separated Single/Divorced Separated Foreclosure in the last 5 years? Home Number: State: Zip:
Em p loy men t In f or mat i on
SSN:
Occupation/ Title: Address: Work Number City: Monthly Gross Base Income: State: Zip
Co-Bu yer Inf or mat ion
Monthly OT/Bonus/Commission
Start Date: (mm/dd/yyyy) Previous Employer: (If less than 2 years at current)
Years in this line of work: 1-2 3-6 7-10 11> Length of Employment Occupation/ Title:
Bankruptcy in the last 7 years?
Rent:
Own:
Monthly Payment:
Phone:
Real Estate
Other Owned Property: Property Address (S=sold, PS= pending sale, R=rental) $ $ $ Bank Name
Present Market Value $ $ $ Balance Balance: Yes No
Mortgage & Liens
Gross Rental Income $ $ $ $ $ $
Mortgage Payments $ $ $
Ins., Maint., Taxes & Misc. $ $ $
Net Rental Income
Source of Down Payment and Amount:___________________, $________________ Home Equity Line of Credit: If yes, Amount Available: ! $_____________________ If yes, Estimated Proceeds: $__________ ) Ofce ( ) Email: __________________________
Assets
Bank Name Do you intend to sell your home in order to purchase this home: Preferred form of contact: Borrower Co- Borrower via
Home (
Authorization to Release Information
! I/We certify that the information provided in this application is true and correct as the date set for opposite my/our signatures on this application and acknowledge my/ our understanding that any intentional or negligent misrepresentation(s) of the information contained in this application may result in civil liability and/or criminal penalties including, but not limited to, ne or imprisonment or both under the provisions of Title 18, the United States Code, Section 1001, et seq., and liability for monetary damages to the lender, its agents, successors and assigns, insurers and any other person who may suffer any loss due to reliance upon any misrepresentation which I/we have made on this application. I/We herby certify that the information provided in this application is true and correct as of the date set forth opposite my/our signature(s) on this application, and acknowledge that any false statement contained in this application may result in civil liability and or/criminal penalties. Borrower:______________________________________________! Co-Borrower:___________________________________________! ! ! ! ! ! ! ! ! Date:___________________________________________ Date:___________________________________________
Pre-Qualification
New Vision Mortgage and Real Estate
