BUYERS PREQUALIFICATION APPLICATION

Applicant

Co-Applicant

First Name                               Last Name

First Name                                 Last Name

Social Security

Social Security

Street Address

Street Address

City

State

Zip Code

City

State

Zip Code

Work Phone Number

Work Phone Number

Home Phone

Home Phone

Mobile Phone

Mobile Phone

Fax Number

Fax Number

Email Address

Email Address

Employer

Employer

Monthly Gross Income/Salary:

Monthly Gross Income/Salary:

Other Income:

Other Income:

Liquid Assets Checking/Savings/Money Market:

Liquid Assets Checking/Savings/Money Market

401K, 401B, IRA, Etc…

401K, 401B, IRA, Etc…

Stocks/Bonds/Mutual Funds/CD’S

Stocks/Bonds/Mutual Funds/CD’S