Mortgage Loan Pre-Qualification Worksheet
Please provide the following information and sign as indicated. Please FAX to one of the numbers below or return to any Branch Location.
Loan Amount Requested $ Purchase or Refinance? If Purchase, Amount of Down Payment $
APPLICANT (Please Print)
First Name Credit Union Account # (type NEW if you are not a member) Middle Initial Last Name Birth Date (mm/dd/yyyy)
Social Security # (000-00-0000)
Street Address Do You Currently Rent? ■ YES ■ NO
City
State
Zip Code
Lived Here Since (mm/dd/yyyy)
If “YES”, what is your current monthly rent payment? $ Home Phone # (000-000-0000)
Email Address Current Employer
Cell Phone # (000-000-0000) $ Gross Monthly Salary
Employer’s Phone # (000-000-0000)
Employed Since (mm/dd/yyyy)
Please skip this section if you do NOT have a Co-Applicant
CO-APPLICANT (Please Print)
First Name Credit Union Account # (type NEW if you are not a member) Middle Initial Last Name Birth Date (mm/dd/yyyy)
Social Security # (000-00-0000)
Email Address Current Employer
Home Phone # (000-000-0000)
Cell Phone # (000-000-0000) $ Gross Monthly Salary
Employer’s Phone # (000-000-0000)
Employed Since (mm/dd/yyyy)
AUTHORIZATION TO REQUEST A CREDIT REPORT
I/We hereby authorize Freedom First Credit Union to obtain a credit report in connection with a Pre-Qualification Mortgage Loan.
Applicant’s Signature Co-Applicant’s Signature Date
Providing the following items is necessary if you would like for us to provide a pre-qualification letter for your use. PLEASE ATTACH THESE DOCUMENTS TO THIS WORKSHEET COPY OF THE MOST RECENT PAY STUB (Applicant and Co-Applicant)
Date
for office use only
Referring Employee Branch
Phone: 540-389-0244
P.O. Box 1999 • Salem, VA 24153 Fax: Roanoke — 540-302-0098 Fax: NRV — 540-951-2165
Rev. 05/07