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Pre-Qualification Form Fill out this Form for a FREE, No Obligation Quote & Loan Pre-Approval (please fill out completely, all information confidential) * Indicates Required Field This form is secure. We respect your privacy and we guard your data carefully. First Name * Last Name *  Co-Applicant First Name Co-Applicant Last Name Street Address *  City *  State CALIFORNIA Zip *  Social Security # XXX-XX-XXXX - - *   Why do you need this? Co-Applicant Social Security # XXX-XX-XXXX - - Main Contact Home Phone XXX-XXX-XXXX ( )- - *  Main Contact Work Phone XXX-XXX-XXXX ( )- - * ext. Annual Household Income * Estimated Value of Home   Desired Loan Amount   Current Loan Amount (If Refinancing) Current Interest Rate (If Refinancing) 0 4 5 6 7 8 9 10 11 12 13 14 15 N/A . 00 125 25 375 5 625 75 875 N/A % Credit Rating Please choose: Poor Fair Good Excellent   Estimated Value of Home   Estimated Minimum Monthly Debt Payments Other Than Housing Expenses (excluding utilities) Occupation   Years In That Line of Work Please Choose... 2+ 1 - 2 Less than 1   Email Address *  Preferred Contact Method Please Choose... Phone at Home AM Phone at Home PM Phone at Work AM Phone at Work PM Email Me   Additional Message By clicking "Submit Form", I agree to be contacted by a real estate professional and to have my credit run. I am aware that I can request a FREE copy of my credit report. Your privacy is very important to us and none of your information will be rented, shared or sold and will remain completely confidential. Please see our Privacy Policy. email us: mortgages@preferredhomeloans.com

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