Mortgage Pre-Qualification Intake

Mortgage Pre-Qualification Intake

Start your pre-qualification. A licensed loan officer will review your answers and contact you to complete your application through a secure link. Please do not enter your Social Security number, bank logins, or full account numbers on this form — those are collected securely later.
Raúl Mayorquin, Broker/CEO · Lic. #3086240 · (786) 223-2583 · raulm@myrealityrealty.com · myrealityrealty.com · Doral, FL
A. Borrower information
Full name
Email address
example@example.com
Cell phone
Please enter a valid phone number.Format: (000) 000-0000.
Preferred language
Current address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
How long at this address?
You currently
B. The loan you want
Purpose
Property type
Where is the property?
Estimated purchase price
Down payment planned
First-time homebuyer?
Target timeline
Interested in down-payment assistance programs?
C. Employment & income
Employment status
Employer name
Job title / type of business
Time in this line of work
Gross monthly income
Other monthly income (optional)
Is a co-borrower applying with you?
If yes, co-borrower name + email
D. Financial snapshot
Credit score range
Total monthly debts
Down payment funds are in

Other
Bankruptcy or foreclosure in the last 7 years?
Anything the loan officer should know?
Consent to be contacted
This form is a pre-qualification intake only — it is not a loan application, not a commitment to lend, and submitting it does not pull your credit. The official application (Form 1003) is completed afterward with the loan officer through a secure portal. Equal Housing Opportunity.
Should be Empty:

Mortgage Pre-Qualification Intake

A. Borrower information

B. The loan you want

C. Employment & income

D. Financial snapshot