Prequalify

Fill out this form to prequalify for a home.  No charge to you!
The form must be completely filled out in order to complete the report.

Borrower

Full Name:

Address:

City:

Zip:

Home Phone:

Work Phone:

Best Time to Call:

Social Security #:

Date of Birth:

Co-borrower

Full Name:

Address:

City:

Zip:

Home Phone:

Work Phone:

Best Time to Call:

Social Security #:

Date of Birth:

  INCOME

  WORK HISTORY FOR THE LAST TWO YEARS

Borrower

Co-Borrower

Employer:

Employer:

Years:

Years:

Employer:

Employer:

Years:

Years:

  GROSS PAY BEFORE TAX DEDUCTIONS

Borrower

Co-Borrower

Monthly Earnings or Hourly Wage:

Monthly Earnings or Hourly Wage:

Other Income:

Other Income:

Other Income:

Other Income:

Total Monthly Income:                                                                                                        $

If married how long:   

How many dependants including children & self:

  OBLIGATIONS

Creditor:

Mo. Pmt $:

Creditor:

Mo. Pmt $:

Creditor:

Mo. Pmt $:

Creditor:

Mo. Pmt $:

Day Care:

Mo. Pmt $:

Child Support:

Mo. Pmt $:

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Old West Realty and Development

Dan Whitney, Designated Broker
Tucson, AZ             520.954.7778

danw@hudhomestucson.net

 

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