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MORTGAGE PRE-QUALIFICATION

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					                                         MORTGAGE PRE-QUALIFICATION
This e-mail address will receive a secure e-mail notification informing you of the results regarding this request. If you do not have an e-mail address
that is able to receive this information do not complete our on-line pre-qualification form. Please contact a local Northwest Savings Bank Office
   or call toll free at 1-877-672-5678 (please choose option #3) and a loan officer will be happy to take your pre-qualification via phone.
                                   Thank you for your interest in Northwest Savings Bank's Pre-qualification Program.


                                                           Applicant Information


                   :

First Name:

Last Name:

Middle Initial:

Social Security Number:

Date of Birth:

Home Phone Number:

Work Phone Number:

Years at Current Residence:

Own/Rent/Other:

Current Address:

City:

State:

Zip:

Current Employer:


Position or Title:

Number of Years with current employer:

Prior Employer - if employed less than 2 years with
current employer :
Number of Years in similar line of work- If employed
less than 2 years with current employer:



Number of Years with prior employer:


Gross Monthly Income (exclude commissions, bonus,
overtime etc.) :

Additional Monthly Income: (Include commission,
bonus, overtime, child support/alimony, etc.) :

If receiving Child Support please indicate age of
dependant(s). :

Year to Date Gross Income (Include commission,
bonus, overtime, child support/alimony, etc.):

Last year Gross Income (Include commission, bonus,
overtime, child support/alimony, etc.):




                                              Co-Applicant Information



                  If this is a joint Mortgage Pre-Qualification, items in red are required information.

Last Name:

First Name:

Middle Initial:

Social Security Number:

Date of Birth:

Home Phone Number:

Work Phone Number:

Years at Current Residence:

Own/Rent/Other:

Current Address:
City:

State:

Zip:

Current Employer:


Position or Title:

Number of Years with current employer:

Prior Employer - if employed less than 2 years with current
employer :

Number of Years in similar line of work- If employed less than 2
years with current employer:

Number of Years with prior employer:

Gross Monthly Income (exclude commissions, bonus, overtime
etc.) :

Additional Monthly Income: (include commission, bonus,
overtime, child support/alimony, etc.) :

If receiving Child Support please indicate age of dependant(s). :

Year to Date Gross Income (Include commission, bonus,
overtime, child support/alimony, etc.):

Last year Gross Income (Include commission, bonus, overtime,
child support/alimony, etc.):




                                      Combined Applicant Information

The purpose of this request is to be prequalified for a:

    Purchase         Refinance      Home Equity

If purchasing, how much will be used as a down payment? :

    0-4%       5-19%        20+%


If refinancing or obtaining a home equity loan, please estimate the value of the subject property. $




Current Monthly Rent or Mortgage Payment
Total of Monthly Debt payments (please complete list below):

  Alimony/Child support $

  Home Equity Loans $

  Credit Cards $

  Student Loans $

  Auto Loans $

  Other $

  TOTAL $

 Once prequalified and prepared to proceed with this transaction, formal application will be completed by;
 (please choose one of the following):

      appling personally at a local Northwest Savings Bank Office.

       appling using Northwest Savings Bank's secure online application. (When prepared to apply online,
 visit www.nwsb.com - click "Loan Center" and choose "Mortgage Loans" or "Home Equity Loans").


 If choosing to apply personally, which office location is most preferred?

 If interested in working directly with a specific loan officer, please indicate loan officer name.



                                                                     Applicant                Co-Applicant

                                                                     Yes or No                  Yes or No


 1.Are you a Co-Signer or Co-Maker on a Loan?

 2.Are there any Outstanding Judgments Against You?

 3.Have you been Declared Bankrupt in the past 7
 Years?

 4.Have you had a Foreclosure/Given Deed in Lieu in
 the last 7 Years?

 5.Are you a party to a Law Suit?

 6.Is any part of the Down Payment Borrowed?

 7.Are you a U.S. Citizen?

 8.If you own a home, will it be sold?
Please Note : This form is only a pre-qualification for a mortgage. If you wish to apply for a mortgage after
you receive the results of this request, you will be required to complete a separate mortgage application. A
mortgage application can be completed by returning to www.northwestsavingsbank.com and applying on-line
or by contacting a Northwest Savings Bank Office in your area.

NEW YORK RESIDENTS ONLY: A consumer report may be requested in connection with this application or
in connection with updates, renewals or extensions of any credit granted as a result of this application. Upon
my request, I will be informed whether or not a consumer credit report was requested, and if so, the name
and address of the agency that furnished the report.

OHIO RESIDENTS ONLY: The Ohio laws against discrimination require that all creditors make credit equally
available to all credit worthy customers and that credit reporting agencies maintain separate credit histories
on each individual upon request. The Ohio Civil Rights Commission administers compliance with this law.

I/we understand that by submitting this pre-qualification, Northwest Savings Bank has permission to
obtain and review my/our credit (Multiple Applicants constitute a joint request). This review will be
preformed in order to determine my/our pre-qualification status for a mortgage loan. Verification or
reverification of any information provided by me/us may be made at any time by the lender, its
agents, successors, and assigns (either directly or indirectly through a credit reporting agency or
from any source stated above). The Lender, its agents, successors and assigns will rely on the
information contained in this pre-qualification and I/We have a continuing obligation to amend and/or
supplement the information provided if any of the material facts which I/we have represented change.
I/we certify the information provided is true and correct as of the date of my/our signature(s) and
acknowledge that any intentional misrepresentation may at the lender's sole discretion void this
request and all commitments made in conjunction therewith by the lender. I/We understand that by
submitting this pre-qualification for approval I/we agree with all information provided in this
document and do hereby attach my/our electronic signatures by typing my/our name(s) and date(s)
below.

Thank you for your interest in Northwest Savings Bank's pre-qualification program.


                                                                     Date:
 Applicant Typed Signature:
                                                                     Date:
 Co-Applicant Typed Signature:

Please allow us one business day to process your request.


WHEN COMPLETED WITH THIS APPLICATION, ONLY CLICK THE SUBMIT BUTTON ONCE. THE APPLICATION MAY
TAKE A COUPLE MINUTES TO PROCESS. WE APPRECIATE YOUR PATIENCE.




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