PreQualification Form

1

Are you a United States Citizen?

YESNO

2

Please Enter your First and Last Name

First Name

Last Name

3

Please Enter your email address

example@example.com

4

Please Enter your phone number

Please enter a valid phone number.

5

What is your annual income?

$27,000 - $47,000

$47,000 - $67,000

$67,000 - Higher

6

Is your credit score above 650?

YESNO

7

When was your most recent refinance, credit limit increase, loan or credit card opened?

1 - 2 months ago

3 - 4 months ago

5 - 6 months ago

6 months or longer

8

Do you have any missed payments, collections or anything derogatory on your credit report in the past 2 years?

YESNO

9

Do you have at least 3 open accounts that are 6 months or older listed on your credit report?

YESNO

10

Have you ever filed bankruptcy?

YESNO

11

Was the bankruptcy discharged more than 2 years ago?

YES

NO

I've never filed bankruptcy.

12

Is your credit utilization less than 60%?

YESNO

13

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