Mortgage Application - Jason Crouch

Borrower Info

Please complete the information below. This information is used for mortgage pre-qualification purposes only and is kept confidential.

Borrower Full Legal Name *

First

Last

Please enter your full legal name exactly as it appears on your government-issued ID.

Email Address *

Please enter the best email address where we can contact you regarding your mortgage pre-qualification.

Phone Number *

Please enter the best phone number where we can reach you regarding your mortgage pre-qualification.

Date of Birth *

Please enter your date of birth (MM/DD/YYYY).

Social Security Number *

Your Social Security Number is required to complete a mortgage pre-qualification and to verify credit. This information is transmitted securely and is never emailed.

Marital Status *

Please select your current marital status. This information is required for mortgage qualification purposes.

Number of Dependents *

Enter the number of dependents you support, excluding yourself.

Ages of Dependents *

List the ages of all dependents separated by commas (example: 3, 7, 12).

Current Street Address *

Please enter your full current address (street, city, state, and ZIP code).

Length of Time at Current Address *

Please enter how long you have lived at your current address (example: 1 year 6 months).

Housing Status *

Please select your current housing situation.

Previous Address (if less than 2 years at current address)

If you have lived at your current address for less than 2 years, please enter your previous address (street, city, state, and ZIP).

Monthly Rent Amount (if renting)

If you currently rent, please enter your monthly rent payment.

Credit Authorization Acknowledgment *

I understand and authorize that a credit report may be obtained as part of this mortgage pre-qualification process.

By checking this box, you acknowledge that a credit report may be pulled to evaluate your mortgage eligibility. This does not obligate you to proceed with a loan.

PROPERTY INFORMATION

The following information relates to the property you are purchasing or refinancing.

Loan Purpose *

Please select whether you are purchasing a home or refinancing an existing property.

Property Address *

Please enter the full address of the property (street, city, state, and ZIP). If you have not identified a property yet, type "TBD".

Estimated Purchase Price / Current Property Value *

For purchases, enter the estimated purchase price. For refinances, enter the estimated current value of the property.

Estimated Loan Amount *

Enter the estimated loan amount you are seeking. If unsure, provide your best estimate.

Property Type *

Please select the type of property.

Occupancy Type *

Please select how the property will be occupied.

EMPLOYMENT & INCOME

The following information is used to verify employment history and income.

Borrower Employment Status *

Please select your current employment status.

Borrower Employer Name *

Enter the name of your current employer. If self-employed, enter your business name.

Borrower Employer Address *

Enter your employer’s street address, city, state, and ZIP code.

Borrower Employer Phone Number *

Enter your employer’s main phone number.

Employment Start Date *

Enter the date you started with your current employer (MM/YYYY).

Borrower Current Monthly Gross Income (Before Taxes) *

Enter your current gross monthly income before taxes.

Job Title *

Please enter your job name or title.

Will there be a co-borrower on this loan? *

Please indicate whether there will be a co-borrower applying with you on this loan.

CO-BORROWER INFORMATION

Complete this section ONLY if there will be a co-borrower on the loan. If no co-borrower will be applying, please leave the following fields blank.

Co-Borrower Full Legal Name

First

Last

Please enter the co-borrower’s full legal name exactly as it appears on their government-issued ID.

Co-Borrower Date of Birth

Please enter the co-borrower’s date of birth (MM/DD/YYYY).

Co-Borrower Social Security Number

The co-borrower’s full Social Security Number is required to complete a mortgage pre-qualification and verify credit. This information is transmitted securely and is never emailed.

Co-Borrower Email Address

Please provide Co-Borrowers full email address.

Co-Borrower Phone Number

Please provide Co-borrowers phone number. Example (XXX) XXX-XXXX.

Co-Borrower Employment Status

Please select the co-borrower’s current employment status.

Co-Borrower Employer Name

Enter the name of the co-borrower’s current employer. If self-employed, enter business name.

Co-Borrower Employer Address

Please provide the FULL address of Co-Borrower's current employer.

Co-Borrowers Employer Phone Number

Please provide the phone number for the Co-Borrowers current employer. Example - (XXX)XXX-XXXX

Co-Borrower Employment Start Date

Enter the date the co-borrower started with their current employer (MM/YYYY).

Co-Borrower Current Monthly Gross Income (Before Taxes)

Enter the co-borrower’s current gross monthly income before taxes.

vehicle Type Accounts

Co-Borrower Job Title

Please provide Co-Borrowers job title.

ADDITIONAL QUESTIONS & DECLARATIONS

Please answer the following questions accurately. These items may impact your loan eligibility or documentation requirements.

Do you pay child support or alimony?

Child support or alimony may need to be considered for qualification purposes.

Do you receive child support or alimony?

Child support or alimony may need to be considered for qualification purposes.

If you answered YES to either of the questions above, please provide explanation below with correct monthly amounts

We must know the exact amount of monthly child support/alimony paid or received and for how long those are required to be paid/received.

Have you ever served or do you currently serve in the military?

Military service may qualify you for VA loan benefits.

If yes, are you planning to use your VA loan benefits?

Have you made any large deposits into your bank accounts in the last 60 days that were not from payroll?

Large or unusual deposits may require additional documentation.

Have you purchased a vehicle or opened any new loans or credit accounts in the last 60 days?

Recent credit activity may affect loan qualification.

Will you be getting a GIFT from a relative to be used towards down payment/closing costs?

Have you filed for Bankruptcy or had a Foreclosure in the last 7 years?

If you answer YES, more information will be needed as a follow up and could affect financing availability.

Is there anything else you would like us to know about your financial situation?

Optional: Provide any additional information that may be helpful for your mortgage pre-qualification.

ASSETS

Please provide information about your assets. This includes bank accounts, retirement accounts, and any other real estate you own.

Approximate Total Balance of All Bank Accounts *

Please enter the approximate combined balance of all checking, savings, and money market accounts.

Approximate Total Balance of All Retirement/401K Accounts *

Please enter the approximate combined balance of all retirement/401K accounts.

Do you currently own any other real estate? *

Include rental properties, vacation homes, or any other real estate owned.

If yes, please provide details of other real estate owned

Include property type, address, loan associated with, rental income and approximate value or mortgage balance if known.