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Pre Qualify with

LUXURYMORTGAGECORP

If you wish to be pre-qualified for a mortgage, please provide the information requested. When you are done please click on the continue button. If you do not have the information to complete a particular part of this application or, if you are not comfortable providing information on-line you may leave it blank.

Please complete the information below for the borrower and co-borrower (if any).
	Borrower	Co-borrower
First Name & Middle Initial
Last Name
Home Phone (incl. area code)
Business Phone (incl. area code)
E-mail address

Please complete the information below for the borrower and co-borrower (if any).
	Borrower	Co-borrower

Present Address - Street
Present Address - City, State, Zip
Rent or Own?	No. of years	No. of years
Yrs. of employment at current job
Yrs. employed in current line of work/profession
Are you self employed?
Total Monthly Payments on debts^*
Funds available for down payment, closings costs and reserves^*
* = Estimated

Monthly Income Information
Gross MonthlyIncome	Borrower	Co-Borrower
Base Empl. Income*
Overtime
Bonuses
Commissions
Dividends/Interest
Net Rental Income
Other**

*Self Employed Borrower(s) may be required to provide additional documentation such as tax returns and financial statements.
**Notice: Alimony, child support, or separate maintenance income need not be revealed if the Borrower(B) or Co-Borrower(C) does not choose to have it considered for repaying this loan.

How did you hear about us?
Purpose of Loan
Property will be
No. of Units
Year Built
Subject Property Address
Street
City, State, Zip
Property value	$
Loan Amount	$
No. of Years
Loan Type
Interest Rate Expected	%

Please enter any comments or questions here:

Illinois License

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