Borrower Information
Full Name:
Social Security #:
Address:
City:
State, ZIP:
Number of People in your household:
Home Phone Number:
Work Phone Number:
E-mail address:	If you don't have an E-mail address leave it blank.
Time of day that it is best to contact you:
	AM PM
Employer:
Employers Phone Number:
Are You Self Employed:	YES NO
Length of Employment at Current Employer:	Years
Gross Income per Month:	$
Date of Birth:
Credit History:	Excellent Good Some Credit Problems Major Credit Problems Don't Know
Co-Borrower Information
Full Name:
Social Security #:
Address:
City:
State, ZIP:
Number of People in your household:
Home Phone Number:
Work Phone Number:
E-mail address:
	If you don't have an E-mail address leave it blank.
Time of day that it is best to contact you:
	AM PM
Employer:
Employers Phone Number:
Are You Self Employed:	YES NO
Length of Employment at Current Employer:	Years
Gross Income per Month:	$
Date of Birth:
Credit History:	Excellent Good Some Credit Problems Major Credit Problems Don't Know
Loan Request
Amount Requested:	$
Type of Loan:	Purchase Refinance
Property Information
Address:
Estimated Value Currently:	$
Year Purchased:
Original Price:	$
Type of Property:	Primary Second or Vacation Investment
Purchase Amount:	$
Loan Information
Mortgage Balances:
First:
Amount:	$
Held By:
Payment:	$
Second:
Amount:	$
Held By:
Payment:	$
Third:
Amount:	$
Held By:
Payment:	$
Other:
Amount:	$
Held By:
Payment:	$
Liabilities
Creditor:
Amount Owed:	$
Monthly Payment:	$
Creditor:
Amount Owed:	$
Monthly Payment:	$
Creditor:
Amount Owed:	$
Monthly Payment:	$
Creditor:
Amount Owed:	$
Monthly Payment:	$
Creditor:
Amount Owed:	$
Monthly Payment:	$
Other Monthly Debts and Information:
Describe Them Here
By submitting this pre-qualification form, I/we authorize Apple Financial Corp. to check things including, but not limited to, my/our credit history and status and my/our employment status and histories. By submitting this pre-qualification form, there is not any cost or obligation for the borrower or co-borrower.