Springs Mortgage Incorporated Pre-Qualification Mortgage Form
Borrower Information
Name, Home Phone, Social Security Number, Email and Springs Mortgage Authorization are REQUIRED Fields
Borrower's Name (incl. Jr or Sr.):	Social Security #:
Complete Home Ph:	Email:
Age:	Yrs School:
Status:	Married Separated Unmarried (single, divorced, widowed, etc.)
Number of Children:
Present Home Address:
City:	State: Zip:
Property Status:	Own this Property Rent this Property House / Rent Payment: $/mo.
Employment:	Choose One Below Current employment Transfer with Current Employer New Employment
Borrower Employment Information
Name of Employer:
Address of Employer:
City:	State: Zip:
Years at this job:	Years in profession: Position/Title:
Bus Phone w/ Area Code:	-
C0-Borrower Information
C0-Borrower's Name (incl. Jr or Sr.):
Social Security No.:	Complete Home Ph:
Age:	Yrs School:
Status:	Married Separated Unmarried (single, divorced, widowed, etc.)
Present Home Address:
City:	State: Zip:
Property Status:	Own this Property Rent this Property House / Rent Payment: $/mo.
Employment:	Choose One Below Current employment Transfer with Current Employer New Employment
CO-Borrower Employment Information
Name of Employer:
Address of Employer:
City:	State: Zip:
Year at this job:	Year in profession:
Position/Title:
Business Phone with Area Code:	-
Monthly Income Note: If your income is changing in any way from what you are currently receiving, please only list the new income below. Gross Monthly Income    Borrower    CO-Borrower Base Income $ $ Overtime/Commisions $ $ Rental Income $ $ Other Income $ $ What is your military pay grade?
Source of Down Payment / Closing Cost Source    Amount Sale of Current Home $ Savings/Checking Accounts $ Gift/Other Sources $ Down Payment Planned $ If using VA eligibility have you used your eligibility before? Choose One Below Yes No N/A
Assets Checking and Savings Accounts Bank Name & Acct. Balance $ Bank Name & Acct. Balance $ Stock and Other Assets Bank Name & Acct. Balance $ Bank Name & Acct. Balance $ Retirment, 401K, emply. savings: $ Real Estate Assets: $
Liabilities Loans Owed    Payment    Balance Mortgage (if applicable) $ $ Creditor: $ $ Creditor: $ $ Creditor: $ $ Child Support/alimony owed $ $
Payment Goal: Buy selecting the radio button at the end of this statement,I certify that the above information is true and correct. I authorize Springs Mortgage to obtain a credit report in order to make a preliminary determination of a mortgage loan application. I understand that a full loan application and credit report must be completed at a later date. Click if you agree: Yes, I agree:    No, I do not agree:
Preferred Method of Contact: E-Mail Phone Mail
Additional Comments:
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