Loan Pre-Qualification Request

Name:
Email:
Address:(Street)
(City)
(State)(Zip)
Phone:(Home)(Work)
Social Security:(Borrower)(Co-Borrower)

Income

Monthly Gross Salary
Average Bonus
(2 prior years average)
Average Commissions
(2 prior years average)
Other Income
(Interest, Child Support)
Total Monthly Income

Monthly Debts

Car Payments (Monthly)
Revolving Payments
(Minimun Payments)
Installment Payments
(School Loans, Furniture)
Other Debts
(Alimony, Child Support)
Total Monthly Debt

I authorize you to provide American Western Mortgage, all information and documentation that they request. Such information includes, but is not limited to, employment, history and income; bank, money market and similar account balances; credit history; and previous/present mortgage or rental verification.

Borrower: Date:
Co-Borrower: Date:
Referred by (Realtor or Website name): If not, do you need a Realtor referral?:


Janice Hooper
1660 S. Stemmons Frwy. Suite 100
Lewisville, Texas 75067
Phone: (972) 420-7442 Fax: (972) 420-8955