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Red Rose Mortgage Loan Pre-Qualification
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Borrower
Name
First Name:
*
Last Name:
*
Personal Info
Social Security #:
*
Date of Birth:
*
Marriage Status:
Married
Divorced
Separated
Single
Employment Info
Employer:
*
Position:
*
Length of Employment:
*
Gross Monthly Income:
*
Contact Info
Phone(day):
*
-
-
ext
Phone(eve.):
*
-
-
Email:
*
Best Time To Call:
*
Day
Evening
Address
Street Address:
*
City:
*
State:
*
AL
AK
AZ
AR
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Zip Code:
Co-Borrower
(optional - required fields apply only if you have a co-borrower)
Name
First Name:
*
Last Name:
*
Personal Info
Social Security #:
*
Date of Birth:
*
Marriage Status:
Married
Divorced
Separated
Single
Employment Info
Employer:
*
Position:
*
Length of Employment:
*
Gross Monthly Income:
*
Address
Street Address:
*
City:
*
State:
*
AL
AK
AZ
AR
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Zip Code:
Contact Info
Phone(day):
*
-
-
ext
Phone(eve.):
*
-
-
Email:
*
Best Time To Call:
*
Day
Evening
Property/Credit Information
Subject Property Address:
*
Approx Age:
*
Square Footage:
*
Sales Price/Value:
*
Down Payment:
*
Source of Funds:
*
Type of Account:
*
Average Balance:
*
401k, investment, or retirement plan is with:
*
401k, investment, or retirement plan value:
*
Amount of payments monthly on
credit
accounts or obligations:
*
Please explain any credit difficulties:
*
Detail any Bankruptcies, Foreclosures, or Judgements in the last 10 years:
*
I authorize Red-Rose Mortgage to run my credit:
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