e-mail: ahb@fsmirc.com Five Star Mortgage, Inc Attn: Aftab Bhojani
Phone: 972-395-9700 Residential, Commercial, Business, Investment Fax: 972-993-0394
Visit www.fsmirc.com for Daily Rates Pre-Qualification Form MB# 22028
Hand Fill the form using CAPS or BLOCK LETTERS ONLY. Must Sign Below before faxing.
Borrower: __________________________________________________________ SS#: _______________________________
Home/Cell Phone: ______________________________ Work Phone: _________________________ Fax: ______________________
Date of Birth: _________________ DL # _________________ STATE:__________ email: _____________________________________
Current Home Address: __________________________________________ City: __________________ ST: ______ Zip: __________
Self Employed: Y / N How long____yrs. ___mo. What type of business______________________________________
Rent: Y / N Rent/mo. $ ______ How long____yrs. ___mo. Martial Status: married Unmarried Separated
Employer: ___________________________________________________ How Long:____Yrs: ____mo.: Work Phone:_________________
Address: ___________________________________________________ City: __________________ ST: ______ Zip:______________
Gross Salary: $___________ Per Hr / Wk / Mo / Yr - Any OT: $__________ Bonus: $_________ Position: ____________________
Co-Borrower: __________________________________________________________ SS#: _______________________________
Home/Cell Phone: ______________________________ Work Phone: _________________________ Fax: ______________________
Date of Birth: _________________ DL # _________________ STATE:__________ email: _________________________________
Current Home Address: __________________________________________ City: __________________ ST: ______ Zip: __________
Self Employed: Y / N How long____yrs. ___mo. What type of business______________________________________
Rent: Y / N Rent/mo. $ ______ How long____yrs. ___mo. Martial Status: married Unmarried Separated
Employer: ___________________________________________________ How Long:____Yrs: ____mo.: Work Phone:_________________
Address: ___________________________________________________ City: __________________ ST: ______ Zip:______________
Gross Salary: $___________ Per Hr / Wk / Mo / Yr - Any OT: $__________ Bonus: $_________ Position: ____________________
Property will be: Primary Residency Secondary Residence Investment
Purpose of Loan: Purchase Refinance Cash-Out Current Appraised Value:$__________________
Cash Out Requested $________________________
If Refinance, current Mortgage TYPE: Conv. / FHA / VA Current Pmt: (P+I)_____________(T+I)___________
Current Rate: ________% Term: _______yr Loan Balance: $_________________ Loan Age: ______ Any Pre-Pay Penalty: Y / N
Assets: Combined Assets ( Borrower and Co-Borrower)
Cash:$_______________ Bank / on Hand / Other Stocks/Bond: $____________ Other Assets: $____________
Automobile: YR____ Make/Model________________________________________ Market Value: $_____________
Liabilities:
Combined Monthly Obligations ( Borrower and Co-Borrower)
Have you had any late mortgage payments in the last 2 years? Y / N When: ___________ How many:_______________
Have you had foreclosure in the last 7 years? Y / N Bankruptcy in the last 7 years? Y / N How long ago-date: ___________
Do you have any outstanding judgments? Y / N If yes, list: _________________________________________________
Are you obligated to pay alimony, child support, or separate maintenance? Y / N Amount: $_______
Are you obligated to pay Student Loan: Y / N Current Status: _______________ Amount: $_______ Any Late: Y / N
Authorization to Release Credit Information:
I authorize Five Star Mortgage, Inc and/or assigns to obtain my/our credit report and/or any additional information to determine credit
worthiness. The information that is obtained is strictly confidential; a photocopy or facsimile of this authorization may be deemed to be the
equivalent of the original. This pre-qualification is not a loan application. Your loan application will begin upon receipt of a signed Uniform
Residential Loan Application.
BORROWER SIGNATURE __________________________________________ DATE ______________
CO-BORROWER SIGNATURE _______________________________________ DATE ______________
Comments: ___________________________________________________________________________________________________
PLEASE FAX TO 972-993-0394,
1803 E. Branch Hollow Dr, Carrollton, TX. 75007