Sand Dollar, MORTGAGE BROKERS, LLC, Loan Application

Sand Castles Group

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Pre Qualify for a Home

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Instructions
  1. Use this form to request mortgage information.
  2. Please fill out as much of this form as possible.
  3. When finished click on the send button. A representative will contact you.
     A phone number is required.

Borrower Information

Name of Borrower
Address of Borrower
Phone
Do you have dependents?	How many? What Age?
Birth Date
Marital Status
Social Security# of Borrower
Property Address
How Long at Present Address
Is this a	Purchase? or Refinance?
Appraised Value of Home
Loan Amount
Purchase Price
Monthly Income
E-mail Address	*

Employment

Employment
Address of employer
How Long at present employer
Phone Number of Employer

CO-Borrower Information

Name of CO-Borrower
Address of CO-Borrower
Phone
Do you have dependents?	How many? What Age?
Birth Date
Marital Status
Social Security# of CO-Borrower
Property Address
How Long at Present Address
Monthly Income
E-mail Address

Employment

Employment
Address of employer
How Long at present employer
Phone Number of Employer

Assets

Bank Account #1
Name of Bank
Account Number
Balance
Bank Account #2
Name of Bank
Account Number
Balance
Bank Account #3
Name of Bank
Account Number
Balance
Stocks, Bonds #1
Name
Balance
Stocks, Bonds #2
Name
Balance
Stocks, Bonds #3
Name
Balance
Automobile #1
Make
Model
Value
Year
Automobile #2
Make
Model
Value
Year
Automobile #3
Make
Model
Value
Year
Other #1
Name
Value
Other #2
Name
Value
Other #3
Name
Value

Bonita • 27499 Riverview Center Blvd., Suite 234 • Bonita Springs, FL 34134 | Office: (239) 596-2596 • Fax: (239) 596-1165
Pt. Charlotte • 2715 Tamiami Trail • Port Charlotte, FL 33952 | Office: (941) 629-8355 • Fax: (941) 629-8356