                                                   Pre-Qualify Now
             Print this page, fill it in and fax toll free to: 888-798-7801 or scan and email to: gmortgage@comcast.net Home Purpose of loan: (Circle one) (P) Purchase or (R) Refinance

BORROWER INFO
Name:
Soc Sec No.
Street Address:
City/St/Zip
How Long?

Home Phone:
Cell Phone:

Employer's Name:
Street Address:
City/St/Zip
How Long?
Position:
Monthly Income (Gross):
401K / IRA Balance: $
Checking Acct. Balance: $
Savings Account Balance:

NOTE: BY SIGNING BELOW YOUR AUTHORIZATION IS HEREBY
            GIVEN TO PULL A CREDIT REPORT IN YOUR NAME

SIGNATURE:                                                        Date:
CO-BORROWER INFO
Name:
Soc Sec No.
Street Address:
City/St/Zip

How Long?

Home Phone:
Cell Phone:

Employer's Name:
Street Address:
City/St/Zip

How Long?
Position:
Monthly Income (Gross):
401K / IRA Balance: $
Checking Acct. Balance: $
Savings Account Balance:

NOTE: BY SIGNING BELOW YOUR AUTHORIZATION IS HEREBY
            GIVEN TO PULL A CREDIT REPORT IN YOUR NAME

SIGNATURE:                                                        Date:
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