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Online Pre-Qualification

The information you provide here will help us establish where you are now and where you want to be. This information is confidential and will be used for the sole purpose of preparing personal home mortgage financing option proposals for your review.

You may submit this information over the internet by filling in this form and clicking the Submit Application button below, or you may choose to print out the completed form and fax it to 847-439-9914.

 How did you find this Web site? 

GENERAL INFORMATION Borrower Co-Borrower (optional)
Full Name 
Residence address
City, State, Zip Code
Home Telephone  
(with area code)
Fax Number
E-mail Address
Best Time to Reach Me
Social Security Number (optional)
     

PROPERTY INFORMATION

Estimated Value
Cash Requesting
(Estimated Value if Refinancing)
Current Loan Amount
Current Interest Rate

Loan Request

Purchase  Refinance  Cash Out Refinance 

For:  Primary Residence Second Home  Rental

Loan Type

Fixed Rate 30  Fixed Rate 15  ARM Balloon Other

Type of Property

House  Townhome  Condo


EMPLOYMENT INFORMATION Borrower Co-Borrower (optional)
Present Employer 
Address
City, State, Zip Code
Telephone  
(with area code)
Years on This job
Title (if self employed, enter "SE")
Annual Base Income
Annual Bonus Income
Annual Commissions or Self Employment Income

 

LIQUID ASSETS

Approx. Balances in Liquid Accounts
In IRA & 401k Accounts

 

CREDIT HISTORY

Borrower Co-Borrower
Excellent
Good - Some Lates
Some Credit Problems
Major Credit Problems
 Excellent
Good - Some Lates
Some Credit Problems
Major Credit Problems

 

DECLARATIONS

Borrower Co-Borrower (optional)
Yes No Are you a US citizen? Yes No
Yes No Are there any outstanding judgments against you? Yes No
Yes No Have you filed for bankruptcy in the past 7 years? Yes No
Yes No Are you a co-signor or guarantor on any loans? Yes No


 

  
Equal Housing Lender: Illinois Residential Mortgage Licensee
1824 S. Arlington Heights Road, Arlington Heights, IL 60005
Phone: 847-439-9900 • Fax: 847-439-9914

Copyright © 2001-2003 Amerinet Financial, Inc.