PALM COAST FLORIDA REAL ESTATE

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Jon Smith

Phone (386) 503-5533 x23

Fax (386) 446-0323

Home (386) 445-4692

Toll Free (800) 245-0320 x23

Mobile (386) 503-5533

E-Mail

RE/MAX Heritage Realty

1240 Palm Coast Parkway
Palm Coast, FL 32137

Jon Smith, Realtor®

Prequalify For A Loan

To start the loan pre-qualification process, please complete and submit the form below. Items marked in red are important for helping me pre-qualify you for a loan. After I receive this information I will contact you with a few more questions to complete your application.

* Required Fields

About you:
First name:*
Last name:*
Phone number:*	ext.
Best time to reach you:
Your e-mail address:*
Marital status:*

If there is someone else applying with you, please enter their name below:
Their full name:

Your current address:
Street name:*
City:*
State:*
Zip:*

Status:
This loan is for a:*
Your ownership status:*

Address of the property you are buying, if you have decided:
Street name:
City:
State:
Zip:
This property will be a:

Estimate your loan:
Purchase price of the property?* (Do not include commas.)	dollars
How much do you want to borrow?* (Do not include commas.)	dollars
Length of years for mortgage:	years
Annual interest rate:	%
Annual property tax:(if known)	dollars
Annual property insurance: (if known)	dollars

Employment and expenses:
Your employment status:*
Co-borrower's employment status:

What is your occupation or type of business?*


How many months?*
How many months have you been working for your currentemployer? (If self-employed, how long have you had your own business?)	months

What is your total monthly income?*
Please include the income of anyone applying with you.	dollars

Your current monthly housing costs.
(Please include the housing costs of anyone applying with you.)
Rent:
First mortgage:
Second mortgage:
Taxes:	monthly
Homeowner's insurance:	monthly
Homeowner's dues:	monthly

Other payments:
How much do you pay each month on other debts such as car loans and credit cards? Please include the debts of anyone applying with you.	dollars

Additional information you think we should know:


By supplying your contact information, you may be contacted by phone or email by the owner of this website or a member of their professional team.

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Jon Smith, Realtor®

Prequalify For A Loan

About you:

If there is someone else applying with you, please enter their name below:

Your current address:

Status:

Address of the property you are buying, if you have decided:

Estimate your loan:

Employment and expenses:

What is your occupation or type of business?*

How many months?*

What is your total monthly income?*

Your current monthly housing costs.

Other payments:

Additional information you think we should know: