Americom Loans: Prequalification Form

Property Information
Address:
City:
State:
ZIP:
County:
Property Type:
Year Built:
Property Value:	$

New Loan Information
Purpose of Loan:
New Loan Amount:	$
New Loan Type Desired:
Occupancy Type:


Existing Loan Information
Original Purchase Price:	$
Year Acquired:
Amount Owed on 1st Mortgage:	$
Current 1st Mortgage Type:
Current Interest Rate:	%
Current 2nd Mortgage Type:
Current 2nd interest Rate:	%
Property taxes, Annual:	$
Homeowners Insurance, Annual:	$
Association Dues, Monthly:	$


Borrower Information
First Name:
Last Name:
Social Security Number:(xxx-xx-xxxx)
Date of Birth		Month Day Year
Email:
Address (Residence):
City:
State:
ZIP:
Home Phone:(xxx-xxx-xxxx)
Work Phone:(xxx-xxx-xxxx)
Mobile Phone:(xxx-xxx-xxxx)
Fax:(xxx-xxx-xxxx)

Borrower Employment
Current Employer:
Years on job:
Gross Yearly Income:	$
Previous Employer (if < 2 years):
Start Date:(mm/dd/yyyy)
End Date:(mm/dd/yyyy)

Borrower Assets
Current Checking Acct. Balance:	$
Checking Acct. Bank Name:
Checking Account Number:
Current Savings Acct. Balance:	$
Savings Acct. Bank Name:
Savings Account Number:
Investment Acct. (# 1) Company Name:
Investment Account (# 1) Balance:	$
Investment Account (# 1) Number:
Investment Account (# 2) Company Name:
Investment Account (# 2) Balance:	$
Investment Account (#2) Number:
401K Account Company Name:
401K Account Balance:	$
401K Account Number:

Borrower Debt
Auto (#1) Bank Name:
Auto (#1) Monthly Payment:	$
Auto (#1) Balance Remaining:	$
Auto (#2) Bank Name:
Auto (#2) Monthly Payment:	$
Auto (#2) Balance Remaining:	$
Credit Card (#1) Bank name:
Credit Card (#1) Account Number:
Credit Card (#1) Payment:	$
Credit Card (#1) Balance Remaining:	$
Credit Card (#2) Bank name:
Credit Card (#2) Account Number:
Credit Card (#2) Payment:	$
Credit Card (#2) Balance Remaining:	$
Credit Card (#3) Bank name:
Credit Card (#3) Account Number:
Credit Card (#3) Payment:	$
Credit Card (#3) Balance Remaining:	$
Student Loan Amount:


Co-Borrower Information
First Name:
Last Name:
Social Security Number: (xxx-xx-xxxx)
Email:
Address (Residence):
City:
State:
ZIP:
Home Phone:(xxx-xxx-xxxx)
Work Phone:(xxx-xxx-xxxx)
Mobile Phone:(xxx-xxx-xxxx)
Fax:(xxx-xxx-xxxx)

Co-Borrower Employment
Current Employer:
Years on job:
Gross Yearly Income:	$
Previous Employer (if < 2 years):
Start Date:(mm/dd/yyyy)
End Date:(mm/dd/yyyy)

Co-Borrower Assets
Current Checking Acct. Balance:	$
Checking Acct. Bank Name:
Checking Account Number:
Current Savings Acct. Balance:	$
Savings Acct. Bank Name:
Savings Account Number:
Investment Acct. (# 1) Company Name:
Investment Account (# 1) Balance:	$
Investment Account (# 1) Number:
Investment Account (# 2) Company Name:
Investment Account (# 2) Balance:	$
Investment Account (#2) Number:
401K Account Company Name:
:401K Account Balance:	$
401K Account Number

Co-Borrower Debt
Auto (#1) Bank Name:
Auto (#1) Monthly Payment:	$
Auto (#1) Balance Remaining:	$
Auto (#2) Bank Name:
Auto (#2) Monthly Payment:	$
Auto (#2) Balance Remaining:	$
Credit Card (#1) Bank name:
Credit Card (#1) Account Number:
Credit Card (#1) Payment:	$
Credit Card (#1) Balance Remaining:	$
Credit Card (#2) Bank name:
Credit Card (#2) Account Number:
Credit Card (#2) Payment:	$
Credit Card (#2) Balance Remaining:	$
Credit Card (#3) Bank name:
Credit Card (#3) Account Number:
Credit Card (#3) Payment:	$
Credit Card (#3) Balance Remaining:	$
Student Loan Amount:	$

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