Mortgage Information Form English

803 Housing Center - Mortgage Information Collection Form

This information will be used to share with one of our preferred lending partners is an effort to obtain pre-approval for a loan.
Borrower Information
First Name
Last Name
Suffix
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email Address
example@example.com
Current Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Do you Own or Rent at current address?
Monthly Mortgage/Rent Payment
How long have you lived at this address?
Previous Address (complete if less than 2 years at current address)

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
How long did you live at previous address?
Did you Own or Rent at previous address?
Monthly Payment at Previous Address
Marital Status
Borrower Employment Information
Current Employer Name
Years at Current Employer
Employer Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Employer Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Position / Job Title
Pay Type
Hourly Rate (per hour)
Hours Worked Per Week
Annual Salary
Do you have a Co-Borrower?
Co-Borrower Information

Only fill out if Co-borrower Selected as Yes
Co-Borrower First Name
Co-Borrower Last Name
Co-Borrower Suffix
Co-Borrower Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Co-Borrower Email Address
example@example.com
Co-Borrower Current Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
How long has Co-Borrower lived at this address?
Does Co-Borrower Own or Rent?
Co-Borrower Monthly Mortgage/Rent Payment
Co-Borrower Previous Address (complete if less than 2 years at current address)

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
How long at Co-Borrower previous address?
Co-Borrower Own or Rent at previous address?
Co-Borrower Monthly Payment at previous address
Co-Borrower Marital Status
Co-Borrower Employment Information
Co-Borrower Current Employer Name
Co-Borrower Years at Employer
Co-Borrower Current Employer Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Co-Borrower Employer Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Co-Borrower Position / Job Title
Co-Borrower Pay Type
Co-Borrower Hourly Rate (per hour)
Co-Borrower Hours Worked Per Week
Co-Borrower Annual Salary
Property Information
What are you wanting to buy?
Regarding land — which applies to you?
Which Sales Agent is assisting you?
What are you realistically looking for in a monthly payment? (include home, taxes, and interest)
Authorization & Signature
I/We hereby authorize the following information to be shared with the preferred lender of 803 Housing Center's choice. I understand that they lender will contact me via phone within 24-48 business hours of completing this form. I understand I have the choice to not use the preferred lender of 803 Housing Center and this is merely an option that I have. I also warrant that all information provided is deemed correct and reliable to the best of my knowledge.
Borrower Signature
Borrower Signature Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Co-Borrower Signature
Co-Borrower Signature Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Should be Empty:

803 Housing Center - Mortgage Information Collection Form

Borrower Information

Borrower Employment Information

Co-Borrower Information

Co-Borrower Employment Information

Property Information

Authorization & Signature