(Please review all data before submitting to ensure the highest level of accuracy.)
 
 
Required fields are denoted with an asterisk (*)
 
*Please select a type of Qualification Check
*How did you hear about ePrequal.com?
If you would like us to notify your agent that you are successfully ePrequalified, please provide the contact info here: Agent Name:   Agent Company: 
Agent Email:   Agent Phone: 
*Loan Purpose Type   *Occupancy Type    
*Refinance Purpose   Cash Out Amount 
*Property Type
  Contact Information
 
*Applicant Name *First Name     *Last Name     Middle Initial 
*Applicant Current Address *Street#     *Street Name     Unit 
  *City     *State     *Zip 
*Applicant Phone *Home    Work 
*Applicant Email *Email Address 
Applicant Social Security #  
 
   Borrower Information
 
*Co-Applicant Name *First Name     *Last Name     Middle Initial 
*Co-Applicant Current Address *Street#     *Street Name     Unit 
  *City     *State     *Zip 
*Co-Applicant Phone *Home    Work 
*Co-Applicant Email *Email Address 
Co-Applicant Social Security #  
   Existing Property
 
Selling a House?         
Selling Price or Estimated Value Price $   Current Mtg. Bal $
Do you own rental property?    How Many?     Tot Rents     Tot Pmts    
   Loan Information
 
*Expected New Home Price $   Years you expect to live in new house 
*Loan Amount $
Cash for Down Pmt and Costs $   Max housing Pmt you want to spend $ 
*Applicants Monthly Income $      How Long? (Years)    (Months) 
*Co-Applicants Monthly Income $      How Long? (Years)    (Months) 
Other Regular Monthly Income $      How Long? (Years)     
  * This Prequalification assumes you will provide full documentation for income.
   Credit History / Debt
 
Estimated Monthly Credit Card Payment $   Total Auto Monthly Payments $
Other Debt Monthly Payments $
Credit History
Anything else about your credit that might help us in evaluating your loan options?
   Desired Program
 
Anything else that might assist us in evaluating your loan or housing needs?