Mortages - Pre-Application - Loan programs, etc.

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Notice: Filling out this form does not lock in rate nor guarantee rate protection of any kind. Loan applications must be confirmed verbally with an Prime lenders Officer. Please call us at 954.731.8668 if you have any questions or would like to lock in a rate.

Use this form to request mortgage information.
Please fill out as much of this form as possible.
When finished click on the send button.
If you prefer to speak to a loan officer please call 954.731.8668

Please give a phone number so that a loan officer may contact you.

The information you enter on this form will be kept in strict confidence.

PLEASE DO NOT USE DOLLAR SIGNS ($) OR COMMAS ( , ) WHEN ENTERING NUMBERS.

	Mortgage Type:	1st 2nd Home Equity
	Amount Requested:	$

Property To Be Financed (if known)
Address:	Apt. or Unit# :
City:	State:	Zip:

IF REFINANCING FILL OUT THE FOLLOWING INFORMATION and then continue with Form

When did you purchase?	yr. mo.
What was the purchase price?	$
What do you think it is worth today?	$
Do you own other properties?	Yes No	If so how many?

Existing Mortgages		1st Mortgage	2nd Mortgage
Please enter below the monthly information for:	Mgt. Balance	$	$
Taxes & Insurance Monthly Mortgage (Are taxes and insurance included in your payment? Yes)		$	$

IF PURCHASE FILL OUT THE FOLLOWING INFORMATION

When do you expect to purchase?	yr. mo.
When will home be completed?	yr. mo.
What is the purchase price, or how much would you like to finance?	$
What is your down payment?	$
Do you own other properties?	Yes No	If so how many?

Personal Information
	Applicant	Co-Applicant
First Name
Last Name
Social Security Number
E-Mail
Home Phone
Fax
How would you rate your credit?
Are you married to the Co-Applicant?
Best time to contact you?

If purchase address is different than the property address
Did you?	How long?	yrs. mo
Address:	Apt. or Unit# :
City:	State:	Zip:

Current Address (if less than 2 yrs. at current) or If Purchase Actual Address.
Did you?	How long?	yrs. mo
Address:	Apt. or Unit# :
City:	State:	Zip:

Employment History

Applicant

Co-Applicant

Employer Name

Gross Monthly Income*

Your Position (title)

Self-Employed

Yes No

Length with Company

yrs. mos.

Phone Number

Previous Employer (if less than 2 yrs. at current)

Employer Name

Gross Monthly Income

Your Position

Length of time with Company

yrs. mos.

Phone Number

Comments

* Before taxes & deductions

By submitting this on-line application, I/We authorize Prime Lenders Inc. to check such information as my/our credit, business and employment status and history. Submitting this application does not lock-in rate. Please call us at 954.731.8668 if you have any questions.

Prime Lenders Inc.
3511 West Commercial Blvd. Suite 401
Fort Lauderdale, Florida 33309
Phone: 954.731.8668 Fax: 954.731.8228

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