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Online Pre-Qualifying Mortgage Application

*required field
BORROWER INFORMATION
Borrower's Name*
Borrower's E-mail*
Social Security
Date of Birth*
Home Phone* 
Present Address (street, city, state, zip code)
Own Rent No. Years
If residing at present address for less than two years, complete the following:
Former Address (street, city, state, zip code)   
Own Rent No. Years
EMPLOYER
Name of Employer  
Length of Employment 
Business Phone # 
YOUR MONTHLY INCOME
Monthly Salary Before Taxes
Average Monthly Overtime, Bonus or Commissions
Monthly Alimony or Child Support
(Need not be disclosed if not to be considered for repayment of this loan)
Other Monthly Income
Self Employed? (check if yes)
BORROWER'S MONTHLY OBLIGATIONS
(Include the following: Credit Cards, Autos, Student Loans, Installment Loans, etc.)
Creditor

Mo. Payment

Balance

$ $

$

$

$ $
$ $
$ $
$ $
$ $
$ $
OTHER OBLIGATIONS
 

Mo. Payment

Balance

Child Support

$

$

Alimony

$

$

BANK ACCOUNTS
(include checking, savings, etc.)
Institution Name

Balance

$

$

$
$
$
$
$
$
INVESTMENT ACCOUNTS
(include 401k, IRA, etc.)
Account Type

Balance

$

$

$
$
$
$
$
$
CO-BORROWER INFORMATION
Co-Borrower's Name
Social Security #
Date Of Birth
Home Phone # 
Present Address (street, city, state, zip code) 
Own Rent No. Years

If residing at present address for less than two years, complete the following:

Former Address (street, city, state, zip code)

Own Rent No. Years
CO-BORROWER EMPLOYER
Name of Employer
Length of Employment
Business Phone #
CO-BORROWER MONTHLY INCOME
Monthly Salary Before Taxes
Average Monthly Overtime, Bonus or Commissions
Monthly Alimony or Child Support
(Need not be disclosed if not to be considered for repayment of this loan)
Other Monthly Income
Is Co-borrower Self Employed? (check if yes)
CO-BORROWER'S MONTHLY OBLIGATIONS
(Include the following: Credit Cards, Autos, Student Loans, Installment Loans, Child Support, Alimony, etc.)
Creditor

Mo. Payment

Balance

$

$

$

$

$ $
$ $
$ $
$ $
$ $
$ $
OTHER OBLIGATIONS
 

Mo. Payment

Balance

Child Support

$

$

Alimony

$

$

BANK ACCOUNTS
(include checking, savings, etc.)
Institution Name

Balance

$

$

$
$
$
$
$
$
FUNDS AVAILABLE FOR DOWN PAYMENT :
$
Downpayment Source:
$
(checking, savings, equity in home, retirement funds, etc...)
Do you authorize Delta Trust Mortgage corporation to order a preliminary credit report?
YES NO
The information you submit is secure in transit.


 

Delta Trust & Bank is participating in the FDIC’s Transaction Account Guarantee Program.All funds held in non-interest bearing transaction accounts at Delta Trust & Bank are fully guaranteed by the FDIC. Coverage under the Transaction Account Guarantee Program is in addition to and separate from the recent increase in FDIC insurance from $100,000.00 to $250,000.00.

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